Alistair Darling: I can understand the hon. Gentleman's irritation that his prepared question has now been rather overtaken by very recent events—that is very hard, but it happens to the best of us.
	I have the report; I need to consider it. I understand that it comprises some 17 chapters, which I will have to look at, but I intend to lay the order before the House as quickly as possible. All being well, assuming that it gets the approval of both Houses, I hope that it will be in force in February, in ample time for any election that may take place next year, or indeed the year after.

Alistair Darling: No doubt, the prospect of my right hon. Friend standing again was one of the many things that spurred on the commissioners to produce their report. Although I will be personally very sorry to see the Edinburgh, Central constituency disappear as a result of these changes, I am none the less sure that we are all prepared for the new world that we are about to enter.
	On the point that my right hon. Friend makes about the Arbuthnott commission, clearly it is for that commission to decide how to conduct its operations, but I know that its members intend to go around Scotland to satisfy themselves that they are getting Scottish opinion on this issue. It has to be said, in fairness to the commission, that this subject probably exercises a small number of people, but it is important that we get it right so that we do not end up with an electoral system that is so complicated that people cannot understand it. I feel strongly about that, which is why the Electoral Commission, which is independent of us all, should be encouraged to become actively involved in the debate.

Angus Robertson: Do the Government understand that energy transmission charges discriminate against projects north of the border? With a significant renewable energy scheme set for development in the Moray firth, is the Secretary of State not concerned that the current exorbitant charges would, as the company has said, threaten the viability of the project?

Alan Reid: Does the Secretary of State not agree that, once the costs of decommissioning are taken into account, nuclear power is a very expensive option? He recently visited Islay in my constituency, and does he not agree that the Government should devote more to the research and development of wave and tidal power, which has the benefit of bringing jobs to remote parts of the west of Scotland?

Archy Kirkwood: Does not the Minister accept that sickness and disability are two of the biggest contributory factors to economic inactivity in Scotland? Will she assure us that the Government have no plans to restrict access to incapacity benefit in a time-limited way? Will she give a further assurance that organisations that deploy the new deal for the disabled will get proper financial arrangements so that they can do their work properly and do the scheme justice?

Anne McGuire: I would hope that the hon. Gentleman also recognises that although we do not want to go down the specific road of restructuring the DWP in his constituency, which he has raised before, significant Government resources have been invested in his constituency and those throughout Scotland through the new deal and various pilot schemes. I would have thought that he would recognise that there has been a drop in unemployment in his constituency of 54.8 per cent. since 1997, and of 10.1 per cent. since last year.

Alistair Darling: When the hon. Gentleman goes to the march, I wonder whether he will have the straightforwardness to stand up and say that under the Scottish nationalists there would be no British Army, no Royal Navy and no Royal Air force, because that is what they believe.

Gavin Strang: As an Edinburgh Member of Parliament, my right hon. Friend is well aware of the capability of the Royal Scots and that they may go back to Iraq next year. Will he consult the Secretary of State for Defence on the timing of any reduction in the number of battalions available to him? Surely the Government's vision of Britain as a force for good in the world is likely to keep the Army heavily committed in the years to come. Does he accept that this may not be the right time to ask our military chiefs to plan a cut in the number of infantry battle groups that are available to us?

Alistair Darling: I remind my right hon. Friend that defence spending is increasing. I think that I am right in saying that this is the longest single period of sustained increase in defence spending for many years, thanks to the Government's commitment. The Army wants to reduce the number of battalions because of the reduced commitment in Northern Ireland—something that we should all welcome. At the same time, the Army is conscious of the fact it is weak in logistical back-up support to the battalions and regiments deployed on the front line. The argument is being driven by what is necessary for operational reasons. It is not financial. That is why the Army wants to ensure that it gets the best possible solution to support regiments on the front line.
	The answer to my right hon. Friend is that these decisions need to be taken. They affect the ability of the Army to be deployed in future. Putting off a difficult decision is not the right thing to do. We have to take these decisions. It is important that we take time to get them right. A decision has not yet been taken but it will be taken fairly shortly.

Lynda Clark: Since 26 October there have been 118 devolution issues intimated to me. Twenty three devolution issues related to criminal matters including pre-trial delay and self-incrimination. The remaining 95 devolution issues related to civil matters, almost all of which concerned prison conditions.

Anne McIntosh: I am delighted that the interest in the hon. and learned Lady's work is increasing. Last time, she had only 28 devolution issues, I believe. We welcome the increasing interest in her work. What is the legal issue on delivering energy policy in Scotland, particularly renewable energy targets, when energy policy is reserved and planning policy is devolved?

Ann McKechin: I am sure that my hon. and learned Friend will share with me support for the introduction of a corporate manslaughter Bill for England in the Queen's Speech, and the announcement by the Scottish Executive of a similar corporate homicide Bill for Scotland. Can she confirm that it would be her intention to meet Ministers of the Scottish Executive and members of the legal profession of Scotland to ensure that these Bills will effectively dovetail with each other and provide robust protection for workers wherever they may be working in the United Kingdom?

Alan Beith: The Minister is surely well aware that the civil legal aid budget is under constant pressure because of the criminal legal aid budget. Does he not recognise that it needs to be ring-fenced if we are to avoid a situation in which the pressures of criminal legal aid, if not dealt with, result in fewer people having access to the law through civil legal aid?

Archy Kirkwood: The hon. Gentleman's passion for making Parliament more accessible to the public is well known and I encourage him in that endeavour, but I cannot see in the short term any realistic possibility of the Commission being able seriously to contemplate doing some architectural trick that would not prejudice security and would not cost a lot of money.

Adam Ingram: Mr. Speaker, I would like to make a statement concerning the Surrey police papers listing allegations of inappropriate behaviour during Army training.
	I make it clear first that the Army and the Ministry of Defence take issues of bullying, harassment and any form of mistreatment extremely seriously. We cannot compromise on the nature of our training, which must be sufficiently robust to prepare our soldiers for the considerable hazards and rigours of operations. An Army career has never been, and never will be, a soft option, but I would like to make it quite clear that violence and intimidation are not the means by which the Army produces the soldiers it needs. Our policy continues to bear down hard on such behaviour and, as far as is possible, to eradicate it completely from our bases and training grounds. We are succeeding at this. Such behaviour has no place whatever in society and neither is it tolerated in the Army.
	I am aware that the media coverage yesterday of the Surrey police memorandum submitted to the Defence Committee on 13 October has encouraged those who have been calling for a public inquiry on the very sad events at Deepcut barracks. I would like to address those calls by setting out clearly what this document is and what actions are being taken in response to it.
	During the recent investigation of the four Deepcut deaths, Surrey police obtained numerous statements involving allegations of inappropriate behaviour at the base and elsewhere. In their fifth report, published in March 2004, Surrey police alluded to evidence uncovered during their inquiries and indicated that some of those allegations may be subject to further examination in due course.
	At the Army's request, in June 2004 Surrey police provided two confidential schedules containing anonymous individual allegations. The first concerned allegations centred on 1995 and the second on the period 2001–02. A memorandum containing these same schedules was submitted to the House of Commons Defence Committee for its 13 October evidence session with Surrey police and this has been made publicly available. I want strongly to refute the allegation that this is a leaked document, and I would call into question the motives of those in the media who have depicted it as such.
	There are 118 entries in the two schedules, covering 173 separate allegations. Eighty of the entries are from 1995. The level of detail is sparse, much of it is hearsay, and much of the descriptive content is vague. Names have been excluded, as the material was provided in confidence to Surrey police. The nature of the allegations is wide-ranging. Some concern pay discrepancies, but the majority allege some form of physical or sexual harassment. Some of the allegations appear to relate to the same incident or pattern of behaviour. Nine of the allegations concern rape and all but three of those have been investigated or are still under investigation. Of the three not subject to investigation so far, in the police's judgment, two are unsubstantiated hearsay accounts. Investigations to date have resulted in one known conviction. Within the total of nine rape allegations, there is one case of multiple rape, which is currently under investigation by Surrey police.
	Let me make the position on the document clear. In submitting their report, the police set out their views on the material, saying:
	"It is important to point out that, to a great extent, the witness recollection is uncorroborated and untested and thus any examples cited should be treated with necessary and appropriate caution. Many of the examples have not been formally investigated at this time as the details were given more as background information as opposed to specific allegations."
	Surrey police have also made it clear that they will not be making any further inquiries themselves. The schedules have been examined by the Army and, as a result, Surrey police were approached in September 2004 with a view to obtaining consent for the relevant statements to be disclosed to the Royal Military Police. I am advised that Surrey police have contacted the individuals concerned and I understand that only two individuals have agreed to disclosure. The Royal Military Police will begin investigations into those two cases as soon as the relevant details have been made available by Surrey police.
	I have heard others talk about how this document proves that a culture of fear and violence existed at Deepcut barracks. We must be very careful here. This document does not contain evidence. It contains some allegations that have already been investigated and other allegations that are worthy of investigation but that have not yet been tested.
	Let me advise the House on how I intend to proceed. These are serious issues, and while I am satisfied that all that can be done is being done, there is a need for that to be seen to be done. I therefore accept the case for a further review by a fully independent figure and will be announcing details shortly.
	I wish to make one further point, which is to pay tribute to the many instructors and staff at our military training establishments who produce high-quality, excellently trained and superbly motivated young men and women for our armed forces. We should not lose sight of that fact.

Adam Ingram: Let me make it clear to my hon. Friend that there is no intention of a cover-up and nothing I have done to date could lead anyone to that conclusion. Every document has been published and all the material advice that has come to me as a Minister about all the training establishments—not just those of the Army—has been made public. Three reports have been published as a result and I hope that he has had the chance to read them. I know that he takes a close interest in these matters. If he reads, or has read, the third report, he will note the very considerable progress made in attending to some of the key issues that were referred to in the first report. There is a trend within the inquiries carried out among the recruits at these establishments, demonstrating a significant change in attitudes towards possible bullying and harassment.
	Progress has been made, but I have to say that we cannot be perfect. No institution in the world is perfect. We will have bullying, we will have harassment and we will have unsavoury incidents. We have had them in the past and no doubt will in future. What we have to do, and what we are seeking to do, is to create a zero tolerance attitude towards those problems. We have tried to secure a culture within all the training establishments that encourages such openness. If anyone has been subjected to any wrongdoing, they should refer it appropriately. I make that plea time and again.
	My hon. Friend asked about the status of what I have announced today. My preferred option—let me be clear about it—was to await the House of Commons Defence Committee inquiry, because it has been an authoritative, detailed and methodical examination. We do not know what the conclusions will be, but it seemed to me that waiting for it to finish and then dealing with its conclusions would be the best option. All of what happened yesterday, especially in the way that it was presented as a leaked report, has changed that. The hon. Member for Aldershot was right to say that it was about whipping up interest in a programme due to be broadcast later in the week, which I believe is disreputable behaviour by some parts of the media. Fortunately, not all the media behave so disgracefully. I am examining the best way forward, including the powers of the review, and I shall, of course, take into account the views expressed by my hon. Friend.

Adam Ingram: There is a process in this country called the coroner's inquest that seeks to establish the cause of death. It is not for Ministers to determine what has happened, and it is not even for the Army. The earlier Deepcut deaths were inappropriately handled by the Army; wrong language was used; and those involved should not have said what they said. Of course, we hope that they will never repeat those mistakes because that is very unsettling for the families. However, I am now faced with a demand for an open inquiry into everything that has ever happened in any barracks over any period. That is what my hon. Friend has just requested. I do not think that that is tenable, bearing in mind all the success that we achieve at Catterick, Deepcut and all the other training establishments. Hon. Members should examine the thousands of young men and women who come through those establishments—look at the output; look at the quality. Our training establishments are not broken machines; they are very professional and successful in doing what they do, and tribute should be paid to them for that.

John Greenway: Until a few years ago, initial training used to take place at Strensall barracks in my constituency. In more than 25 years of living close to the barracks, most of the time as Member of Parliament for Ryedale, I know of no circumstance or events alleged of the kind that appeared in yesterday's newspapers and that have been referred to in the statement. I agree with the Minister that that speaks volumes for what normally happens in the Army. It is stating the obvious that none of this will help with recruitment, but it would help if he would go a little further and reassure the families of those young people who are about to join our famous British Army in which we all take great pride that, if they encounter difficulty, there is a whistleblowing procedure in which they can have trust and confidence.

Adam Ingram: I have good relations with the hon. Gentleman, but I ask him to recognise that, if I used the word "suicide", I corrected it. I said that, if I had used inappropriate language, I should not have done so. He did not recognise that in his question. I am usually very careful in the way that I work through these issues. I make that clear again, and I repeat the point that one death was declared a suicide by an inquest; two were given open verdicts; and one is still to be determined.
	The hon. Gentleman refers to the Skinner case. I have set out the background to that: Skinner was not there at the relevant times, so please stop conflating the two issues. I think that the hon. Gentleman has reached a conclusion: he is saying that there is systematic abuse. I would prefer my independent review to examine that. He perhaps has a closed mind. I ask him to open his mind, and let us examine this in a more open way.

Michael Jabez Foster: My constituents, Mr. and Mrs. Benton, the parents of Sean, will welcome the Minister's openness in seeking a further review, but that very much depends on what that review will be, how wide it will be and how it will be conducted, as has been said already. My right hon. Friend has suggested in the past that the inquest process is a means of further review. May I put it to him that, for the reasons he gave today, much of the evidence could not be put before a court of law? That is why a wider review, with a much wider remit, is necessary to carry out an inquiry, rather than using an adversarial system, to find the truth of what really happened at Deepcut.

Adam Ingram: I am not an expert on this, so I hesitate to be too definitive. However, it seems to me that if any or all of the people who made the allegations wish to make themselves available to the coroner—the one case still to be considered is a matter for the coroner— there is nothing to preclude their coming forward. As I understand the way in which a coroner's powers are defined, there is no constraint on what he can consider. That is one form of open examination, and it is important. The HCDC is also carrying out an investigation, and I do not know who it is has seen. Families will give evidence to the Committee this week, and I do not know what they will say. We will follow the matter very closely and will examine in great detail every allegation that is made.
	I appreciate the welcome that my hon. Friend has given to the openness of our approach. We will continue to be as open and as transparent as we can, bearing in mind that individuals are involved. Perhaps the police did not give us the names, because the individuals did not want their names to be given in a way that would have allowed a more progressive investigation to take place. We must break down that reticence on their part.

Adam Ingram: I do not want to go into individual cases for obvious reasons, but I recognise that there have been occasions in the past of insensitivity and the bad handling of cases—some of it quite dramatic, some of it less so, but none of it acceptable. I hope that all the lessons have been learned. The hon. Gentleman is right to say that an apology is important, but the matter should not rest there. If something wrong has been done, we have to try to discover the background. That is what Surrey police sought to do in relation to the four deaths at Deepcut.
	I have every confidence in the way that Surrey police carried out its investigations and the integrity with which it approached the issue. I just hope that people have confidence in the system. We are now trying to move it forward and are now dealing with the more unsubstantiated information that we have. We must try to get to the bottom of that, and that point applies generally across the board.

Adam Ingram: Our announcement is a recognition that that is the case. I appreciate my hon. Friend's comments about government by public inquiry. If anything happens now, someone pops up and says. "Let's have a public inquiry". We cannot administer the country on that basis, because decisions have to be taken in advance of any inquiry. If something needs to be corrected, it should be identified by the relevant Department and relevant Ministers and corrective action taken. That is what I have done as far as I am able to do on the basis of the information that I have. We do not yet have the new procedure in the Inquiries Bill in law but if it had been available, I might have been able to use it.

Orders of the Day
	 — 
	Debate on the Address
	 — 
	[Fifth Day]

Andrew Lansley: I beg to move, as an amendment to the Address, at the end of the Question to add:—
	"but deplore the absence of any measures in the Gracious Speech which would reduce the burden of centrally-imposed targets, bureaucracy and regulation on the NHS and the Education Service; call on Ministers to implement urgently the action needed to deliver cleaner hospitals and to strengthen school discipline; regret the omission of measures to abolish top-up fees; note that legislation to reduce the size of Ofsted will merely reverse part of the huge increases in its staffing levels since 1997; reject the Government's intention to impose additional fees on those attending further education colleges and deprecate the damage this will cause to adult and vocational education; further regret the carry-over of the School Transport Bill, which will impose extra financial burdens on hard-working families; are concerned at the failure to take forward legislation on mental health in a form that would protect the rights of people with mental health problems and promote their access to treatment; further regret the lack of any proposals in the Gracious Speech to provide effective public health services; and further deplore the absence of measures to promote freedom and independence for health and education professionals or effective choice of patients and parents.".
	Today we move on to debate health and education. My hon. Friend the Member for Westmorland and Lonsdale (Mr. Collins) will later address in detail the education measures—or perhaps the lack of them—in the Queen's Speech.
	The Queen's Speech offered no forward momentum to raise standards in the NHS or our schools. Three years ago, Labour said that it put schools and hospitals first, but they are now being pushed to the back of the queue by Home Office measures prompted by the Government's failure on law and order. We have no health Bills and nothing that would help to raise standards in our schools. There is no vision for our NHS or any room for the politics of hope in the Queen's Speech.
	At the heart of the reforms for which the NHS is crying out is the reduction of centrally imposed targets, bureaucracy and the burden of regulation, but the Queen's Speech contains no measures from the Secretary of State for Health to move us in that direction. Indeed, in the few days since the Queen's Speech we have heard from the Healthcare Commission that it proposes the abolition of star ratings, for which Conservative Members have been calling for a long time. We demonstrated, and many people throughout the NHS entirely agreed, that star ratings were a crude and misleading measure of performance in the NHS. They were centrally imposed by Ministers, but as soon as the scheme was taken out of the hands of Ministers and put into the hands of those who are genuinely charged with delivering improvements to the NHS, the conclusion has been reached that star ratings must be abolished.
	The Government have offered nothing in the Queen's Speech to reduce the burden of targets. People throughout the NHS know that they distort priorities, and we have discussed this many times. Indeed, my right hon. and learned Friend the Leader of the Opposition has stood at the Dispatch Box and challenged the Prime Minister to get rid of targets that force those responsible for infection control measures in hospitals to keep beds and wards open when they should be cleaned for infection control purposes. The National Audit Office has made it clear that those people are overruled by managers in pursuit of the Government's centrally imposed targets. That is a disgrace, but it is only one of a range of illustrations of how targets that are centrally imposed by Whitehall are distorting the national health service's priorities.
	The Government told the National Audit Office that by 2003–04, their NHS plan would bring bed occupancy down to 82 per cent., but that has not happened in practice. All the trusts throughout the country with the top 20 rates of methicillin-resistant Staphylococcus aureus have a bed occupancy higher than 82 per cent., and it is more than 90 per cent. in several. We will not get cleaner hospitals by using the Government's central targets; we will only achieve that in the absence of their interference.
	Even the Government do not believe in their targets. They set a target for reducing the backlog of maintenance in the NHS. The target was the reduction by a quarter of a backlog measured at £3.1 billion by the end of 2004—the end of next month. Last Thursday, however, the Department of Health concluded that it was measuring the target using a flawed methodology, so rather than adhering to the target, it said that it would recalculate the figures. In place of the backlog of maintenance, which would now be not £3.1 billion but £3.2 billion, it has arrived at what it calls, using typical jargon,
	"estimated risk adjusted backlog maintenance"—
	I suppose that the risk in mind was that the target might not be hit. The Department would have had to announce its failure to make any progress towards addressing the £3.1 billion backlog, but instead—lo and behold—its estimated risk adjusted backlog has become £638 million. How interesting.
	The Government do not believe their own targets, but neither do people who work in the NHS. The Government trumpeted the fact that four-hour waiting targets for accident and emergency departments had been met, but only last week, the Nursing Standard carried a report of the Royal College of Nursing Emergency Care Association annual conference. It said:
	"nurses speaking from the floor claimed there was widespread misreporting of the figures that are signed off by chief executives. Some endorse so-called 'gaming', the practice by which patients are transferred only in the final minutes before breaching the target . . . One delegate, who wanted to remain anonymous, won applause from nurses for saying that her trust 'lied' over the A&E waiting time figures it presented."
	The charitable view is that the Department does not know what is going on in the NHS, but the uncharitable view is that it would rather present figures than understand and be honest about what is happening.
	We need fewer targets and less bureaucracy. The cost of bureaucracy in the NHS has increased from £3 billion in 1997 to £5 billion. The number of central administrators in the NHS is rising three times faster than the number of doctors and nurses. I recently visited a hospital at which I was given a list of the inspection bodies that visit it. It is visited by 42 inspection bodies. I referred to that during a meeting at which the Healthcare Commission was represented, but its chief executive said, "No, it isn't 42. We've been counting them and it's 102." Of course the Secretary of State does not believe that, but the Healthcare Commission seems to be more in tune than he is with what is going on in the NHS.

Andrew Lansley: My hon. Friend is right, and I shall come to that.
	The extent to which hospitals have to comply with information requirements is a key consideration. A survey by the NHS Confederation identified that 50 per cent. of the data and information requests made to hospitals play no direct part in the performance management of those hospitals. We have to get rid of that and not only achieve a reduction in compliance costs for front-line services, but ensure that the resources get to the front line, as my hon. Friend said.
	As always, the Secretary of State is all talk about cutting bureaucracy. He does it again today in a written statement, which says how he will cut the number of quangos and save money. Let us take one example. As a result of a public health White Paper five years ago, which the Government have conveniently ignored because they have made no progress on public health, they set up the Health Development Agency. They are now proposing to get rid of it by April 2005. The Government documents published today say that they will abolish it as one of their reductions in the number of quangos. What the documents do not tell us is that the public health White Paper published just a couple of weeks ago says that they will establish a new independent body to implement strategy on their behalf which will, in effect, have the same responsibilities as the HDA. Most of the quangos that the Govt are getting rid of they set up—and they are not really getting rid of them, but redeploying the staff and incorporating them into larger bodies, so there will be fewer quangos with wider responsibilities and more staff. At the same time, however, they are creating new bodies to take over the functions of existing bodies.
	Just the other day, the chief executive of the NHS gave the game away when he said:
	"The department has not been massively affected by either the Gershon or Lyons reports."
	So the Gershon report, for all its vaunted reduction in the cost of bureaucracy across Whitehall, is not having much affect on the Department of Health. The implementation of the changes to taxpayer value that we are discussing with the James committee will affect the Department. As my right hon. Friend the shadow Chancellor of the Exchequer set out just 10 days ago, we now envisage more than £7 billion of savings from greater NHS efficiency, reductions in procurement costs, productivity improvements, reductions in the controls exercised by the central Department of Health, and a reduction in the number of quangos and the amount of bureaucracy in strategic health authorities and primary care trusts.

Nick Gibb: I am listening carefully to my hon. Friend's interesting speech. Is he also aware of the Office for National Statistics survey, which shows that rising inefficiency consumes as much as 9 per cent. of the extra cash put into the NHS? That amounts to a staggering £6 billion a year in inefficiency and waste.

Andrew Lansley: Let me give an example. I am sure the hon. Gentleman knows that finished consultant episodes are a measure of activity levels in hospitals—

Phyllis Starkey: Does the hon. Gentleman accept that much of the increased spending has gone to improve the salaries of nurses, doctors and others within the NHS? That means that my area has the doctors, nurses, physiotherapists, occupational therapists and speech therapists for whom we receive funding, because they are staying within the NHS—and, in particular, in the NHS in the south-east.

Andrew Lansley: Of course there are changes in costs inside the NHS, but incorporated into the calculation of the ONS statistics is a deflator for NHS prices of something like 6 per cent. The figures would have been different had a GDP deflator been applied. An allowance is made for that. The hon. Lady and I know—and I think that my hon. Friend the Member for Bognor Regis and Littlehampton (Mr. Gibb), too, made this point—that this year hospitals are experiencing increases in costs well in excess of that. Part of that is due to increases in contracts and changes in pay, whether they result from "Agenda for Change" or from the consultants contract.
	Hospitals, rightly, are saying that it is all very well Ministers talking about 9 per cent. increases in expenditure, but if costs are rising by more than 9 per cent., how can increases in activity throughout the NHS be delivered? They are asking how that will be possible. There must come a point when people in the NHS find that they have centrally imposed costs from the Government that exceed the willingness of the Government to provide resources. They must arrive at the point where they get the resources, and there are free resources that can deliver growth in the service.
	As we discussed during the debate on the Queen's Speech yesterday, the people's priorities would have been, for example, strengthening school discipline or promoting cleaner hospitals. I will not dwell on promoting cleaner hospitals because we have had debates during which we have challenged the Secretary of State to come forward with the urgent action that is necessary. That is not happening. Perhaps the right hon. Gentleman can tell us why we do not have information from clinical departments that will enable people working in the NHS and those who might be referred for operations to judge where there are cleaner infection-free hospitals and where there are not.
	If there is to be a matrons charter, which the Government have announced, where is the model cleaning contract referred to in that charter but not yet published? It is almost a year to the day since the chief medical officer's report entitled "Winning Ways", which said that there would be a rapid review panel for products and processes. Nothing happened for nine months, and even today, nearly a year on, the so-called rapid review has delivered no additional advice to the NHS.
	The National Audit Office said that four years ago the Department began working on a national infection control manual. I met staff through a Patients Association meeting that I hosted in the House last week, and they said that it would be extremely helpful for infection control teams to have access to such a manual in providing guidance to their hospitals. It is not available, and the NAO found that no substantive action had been taken. "Winning Ways", published a year ago, referred to hazard analysis critical control point methodology, and said:
	"The . . . Inspector of Microbiology and the National Patient Safety Agency will work jointly to ensure that the techniques of . . . (HACCP) are developed for healthcare associated infection".
	A year later, I can find no evidence that that work has been taken forward. Even pilot operations are not under way.
	The Secretary of State's response to all the pressure that we have put on him to deliver action is typical. He talks about nothing more than the importance of dealing with infection, and promises one more target. That target is to reduce the level of MRSA—only the bit that he measures, not the whole of MRSA infection—by half by 2008, as if there is an acceptable level of MRSA infection, equivalent to the level that the Government inherited in 1997. The chief medical officer's report stated, as was made clear in the document published a year ago, that the proportion of staphylococcus aureus in this country that is MRSA is 44 per cent. The proportion in Demark and the Netherlands is just 1 per cent. The Secretary of State's ambitious and challenging target, as he describes it, is to bring the percentage down by half. That is not good enough.
	The chief medical officer said that it was known how the Dutch had been able to achieve such a proportion. They did so through a search-and-destroy mechanism. It is about time there was a search-and-destroy philosophy inside the NHS to identify outbreaks of MRSA infection and destroy it to deliver cleaner hospitals, which is not happening under this Government.

Michael Fabricant: Is my hon. Friend aware that a nursing sister in my constituency was telling me that in a major hospital in Birmingham there is no clear guidance to ancillary staff? She gave the example of water jugs and other crockery being taken from an isolation unit and mixed with crockery—[Interruption.] The Secretary of State laughs, probably because he does not care about MRSA infection. Does my hon. Friend agree with me that if crockery and jugs from an isolation unit, which is known to have MRSA, are mixed with crockery that was previously sterile, it too will become infected, and so in turn will infect other patients?

Andrew Lansley: No, I will move on.
	My hon. Friend the Member for North-West Norfolk (Mr. Bellingham) asked me about deficits. The Labour party is always parading the fact that it is providing additional money for the NHS—but we know what is happening because the strategic health authorities tell us exactly that in their latest document. South-west London is currently reporting a projected total deficit for the year end of £79 million. Norfolk, Suffolk and Cambridgeshire strategic health authority, in my area, is projecting a year-end deficit of £51 million. Avon, Gloucestershire and Wiltshire SHA, in the area of my hon. Friend the Member for Westbury (Dr. Murrison), is projecting a deficit of £27 million. The projection of Surrey and Sussex is £22 million. Throughout the country, 75 primary care trusts and 73 NHS trusts are forecasting deficit. The total across—[Interruption.] From a sedentary position, the Minister of State, Department of Health, tells us that we should go back to the last century and try to examine what the comparison would be. That is terrific.
	I thought that the Government pretended that in the past seven years things had changed. It seems that their argument is that things are the same now as they were in 1996. If the public believe that nothing has changed since 1996, they will look to us for the change that is necessary and not to the Government, who have achieved nothing. If the Minister of State is happy that half way through a financial year 75 PCTs and 73 NHS hospital trusts are forecasting deficits because he and his colleagues have imposed costs on the NHS that are far in excess of the financial resources that are made available, along with unfunded GP contracts, unfunded consultant contracts and risks associated with "Agenda for Change"—

Andrew Lansley: Of course we need a Bill that is right, which is why we called for one in our amendment to last year's Loyal Address. We did not want a Bill that locked people up to satisfy the Home Secretary; we wanted one that gave them the health care that they needed and the access that they were entitled to expect. We do not need a Bill that introduces fear and coercion into what ought to be a therapeutic relationship. The legislation should provide quality care for patients, and compulsion should be a tool of last, not first, resort.
	Before concluding, I shall put some questions to the Secretary of State. The Queen's Speech presages the introduction of legislation on identity cards. Indeed, the Identity Cards Bill has just been published. I do not understand the relationship between the ID card and the NHS, so perhaps the Secretary of State will enlighten us. We are told that the card will be used to facilitate access to NHS services. According to the Bill, however, it could not be used for that purpose until holding such a card is compulsory—according to the Home Secretary, that will be in 2013. In terms of action, therefore, the card is irrelevant, because it will not become obligatory for another decade.
	However, the NHS improvement plan that the Secretary of State for Health published in June says on page 30:
	"The Department of Health is currently considering the development of an NHS Card, which could support smart access to personal data and speed confirmation of access to appropriate care."
	Are there going to be two cards—the NHS card and, later, the ID card—and what will be the relationship between them? Quite separately, the European Union requires us to replace the E111 system. A number of EU member states have already introduced a card for access to their health services that serves as an E111 entitlement when one visits those countries. Surely we will have one of those cards, so where does the ID card fit in?
	Children would not have an ID card but, presumably, to access NHS services they will need an identifier for personal patient records and so on. Whether or not they have an ID card, they will have an identifier already, so what is the point of the identifier on the ID card? Entitlement to NHS services is based on ordinary residence, but the ID card will be based on citizenship. All those problems illustrate the fact that many of the Government's proposals are ill thought-out. There are questions about the NHS and ID cards to which no one seems to know the answer. Perhaps the Secretary of State will tell us later whether he has any answers.
	Our amendment expresses the hope that we will soon have a chance to deliver an NHS that is geared towards patients, not the Department of Health. It will be exclusively concerned with clinical standards, priorities and the needs and wishes of patients, not central targets and the demands of bureaucracy and administrators. It will be geared to give information to patients, with all the positive impacts on quality that that can deliver. It will give choice to patients, because in an era of added consumer pressure that will deliver quality and incentivise people across the NHS to deliver services and ensure that when staff treat patients, they receive the resources that they are clearly not receiving at the moment. It will give people suffering from chronic diseases control of their care, and will increasingly empower them to manage their care to meet their needs. It will give GPs control of their budgets through fundholding. The total purchasing pilots introduced in the latter stages of the last Conservative Government were a great success, but they were abandoned by the present Government who, however, proposed to reintroduce them in a distorted, cut-down form following the failure of their measures.
	Once again, in our amendment we are demonstrating that there is a forward agenda for the health service that will provide freedom and independence for the NHS, choice for patients, and opportunities for the NHS to deliver the care that its staff work hard to deliver. That is our objective, and we will seek to achieve it as soon as the election gives us an opportunity to do so. On that basis, I urge colleagues to support our amendment.

John Reid: First, I congratulate the hon. Member for South Cambridgeshire (Mr. Lansley) on his belated stakhanovite use of the word "patient" six times in the past minute. Unfortunately, for the first 37 minutes of his speech, patients did not feature once. That is indicative of his approach—always on the side of the providers, never on the side of the patients—until at the end of his speech he digs out the peroration written for him by someone, which says, "Mention patients several times."
	Secondly, I entirely accept that the hon. Gentleman does not understand every nuance of the Government's policy on, for example, NHS entitlement cards. I find it less explicable that he did not seem to know that the Conservatives were committed by his predecessor, the hon. Member for Woodspring (Dr. Fox), to an NHS entitlement and identification card. However, I will let him study that and perhaps he can explain to us next time whether the proposal has been abandoned.
	For 38 minutes the hon. Member for South Cambridgeshire managed not to notice the elephant in the room. At no stage, even in those last repetitive uses of the word "patient", was it followed by the word "passport". The central policy of the Conservative party, the patient's passport, which received accolade after accolade from his own leader, was not mentioned once in the 38 minutes of his speech. That speaks volumes about the albatross hanging round his neck. He spent 38 minutes trying to hide the patient's passport. Perhaps that is why he did not mention patients.
	Finally, I am sorry that the hon. Gentleman feels, as he said in his opening remarks, that health and education have not been given the priority that the Government promised them and have been pushed to the back of the queue in all our considerations. It is therefore with particular pleasure that I approach the Dispatch Box for the 297th debate on health in this Parliament and for the 64th debate on health in the past 12 months alone. The complete lack of priority will be obvious from the figures.
	The truth is that health and education have been given every priority by the Government. That is as it should be, because there are few issues that affect people's lives so directly and so crucially as health, where everyone is potentially a patient—the word missing from the hon. Gentleman's speech—and education, where not only parents and pupils have an interest, but we all have an interest as a country.
	My right hon. Friend the Secretary of State for Education and Skills and I welcome the debate today. For the past few years we have been privileged to be involved in travelling a journey in public services—a journey of modernisation and improvement. Opposition Members, who spent most of their time in government moving backwards on public services, find it difficult to understand the concept of moving forward on a journey of modernisation and improvement. We do not underestimate the challenges that remain. The view to the horizon leaves us in no doubt about the extent of those challenges, some of which were mentioned by the hon. Member for South Cambridgeshire and some of which were not. There are still staff shortages—for example, of radiologists, midwives and nurses. Admittedly, we have 80,000 more nurses than under the previous Government, but we still feel that there is a shortage. Combating MRSA is a big challenge for us.
	The hon. Gentleman continually asks us from the Dispatch Box to pursue the search for truth. He should remember the old adage—"When you keep asking for something, be very careful. You might get it." Next week I will publish a factual history of the increase in rates of MRSA over the past 12 years, and it will make very interesting reading, especially for Opposition Members, who seem to feel that the great increase in MRSA rates occurred under the present Government. As we look to the horizon, we know the great challenges that remain.

John Reid: Almost every month we take another step in that direction. I do not pretend, as is sometimes implied from the Opposition Benches, that there is some magic wand that will achieve that. The hon. Member for South Cambridgeshire seems to be incapable of holding two ideas at the same time. He complains that we have any targets at all, then he complains that the target we have set for MRSA is not ambitious enough. He wants a bigger and better target.
	I know that that is not the view of the right hon. Member for Charnwood (Mr. Dorrell), who has held a responsible post in government. We may be forgiven for encouraging some of the younger Members on the Front Bench, who have not held such responsible posts, but the right hon. Gentleman knows that these are difficult and complex issues. He is right that there are lessons that we can learn from abroad, as well as lessons that we ought to develop internally in this country. Month on month we are taking further steps. Next month we are bringing some of the world's leading scientists to this country in pursuit of research on immunity to MRSA. We are examining a range of measures.
	We do not regard the matter as a party political issue, and I thought it was slightly churlish of the hon. Member for South Cambridgeshire not to mention that we invited him and the hon. Member for Sutton and Cheam (Mr. Burstow), the Front-Bench spokesman for the Liberals, to put to us ideas which, if we find that they are practical and would achieve an advance for us, we will willingly adopt. I have never regarded methicillin-resistant Staphylococcus aureus as intrinsically related to either the Labour party or the Conservative party. The figures next week may show that it has crossed party politics.

Paul Burstow: On further steps to deal with MRSA infections in our hospitals, will the Secretary of State look again at the way in which the Government currently collect the statistics? They collect them on a hospital by hospital basis rather than on a specialty basis, in order that decisions can be made about targeting particular problems in particular hospitals. Is it not time to produce specialty-level data so that we can start to target the problem more specifically?

John Reid: We will look at all these matters. We will examine whether collecting data hospital by hospital is sensible, or whether we need to identify particular areas within hospitals where the vulnerable are and operations are carried out. It is a cruel deceit to pretend that it will not be a continual struggle. When I said that within roughly three years I wanted to halve the rate of MRSA, I did not propose that as a ceiling; that is a floor. I hope that we can make more progress, but for the sake of some party political populist slogan I am not prepared to pluck any target out of the air and demand that it be accomplished. That is not responsible politics.
	Looking forward, we can see huge challenges ahead in our attempts to improve and modernise the national health service. However, the retrospective view from the point that we have reached leaves me and most objective observers in no doubt about the significant progress that we have made so far on that journey of improvement.

John Reid: It is not an assertion in the sense that I am saying that that is where we will be without a shadow of a doubt. A target is just that—an aim and objective. Where did I get that target? I got it on official advice as to what would be possible if we continued to combat MRSA. The advice was that within three years, with the measures that we have now taken in our continual struggle, it would be possible first to stop the growth of MRSA, which has happened under both Governments, then to achieve a decline, and then a decline of significant proportions. That was done in the way in which any Minister would do it. It was done after consultation, discussion, testing and inquiry from officials.

John Reid: The right hon. Gentleman may have missed it, but I did not once claim—I repeated the point three times—that the achievement was down to the Government; I claimed that it was down to NHS staff. I ask Conservative Members to do what the right hon. Gentleman did in 30 seconds and what Conservative Front Benchers were unable to do in 38 minutes—pay credit to the NHS. That is what I object to.
	I celebrate when lives are saved through the NHS. All Labour Members celebrate the fact that, 60 years after the formation of the NHS, a young child born in this country will live nine years longer than they would have done before the NHS was founded. Although the right hon. Gentleman is never churlish—he has led that vast organisation, with all its faults and virtues—I cannot hear roars of celebration from Conservative Front Benchers,
	Conservative Front Benchers do not celebrate the fact that, compared with the peak, 456,000 fewer people are on waiting lists. Waits of more than nine months for hospital admission have reduced from more than 118,000, which was the last Government's legacy, to virtually nil today. Nineteen out 20 people are seen, diagnosed and treated by our NHS staff within four hours—a world record. I cannot hear roars of applause from Conservative Members.
	None of those achievements is reflected in the efficiency gains. If one waits three months, three weeks, three days or three years, it makes no difference to the present method of calculating efficiency, which is why I have said that the current method is absurd. Rather than using those calculations to beat NHS staff over the head, let us point out that the practical improvements carried out by NHS staff are not currently represented in those statistics.
	Managers are the bête noire of the hon. Member for South Cambridgeshire. The NHS has about 38,000 senior managers, which is a ratio of about 3 per cent. to other staff and about one quarter of the figure in private health care. The 38,000 senior managers compares with about 400,000 nurses and about 130,000 doctors. Let us not use the weasel words that the number of managers has increased at three times the rate for doctors, because, although that might be statistically accurate, like damned lies, statistics can be misleading. It would be better to say, "However, that means an increase from 25,000 to 38,000 senior managers out of 1.3 million staff. The 38,000 figure compares with about 500,000 doctors and nurses and another 500,000 people who work in the other 71 professions in the NHS, 84 per cent. of whom provide front-line care." That is a balanced summary of what the NHS has achieved on manpower.
	The hon. Member for South Cambridgeshire did not mention the huge improvements in health or, indeed, the huge improvements carried out under my right hon. Friend the Secretary of State for Education and Skills. Spending is up: since 1997–98, schools' recurrent funding has risen in real terms by £870, which represents a 30 per cent. increase per pupil to £3,740 in 2004–05. Class sizes are down: the overall pupil- teacher ratio in nursery, primary and secondary schools has fallen from 18.6:1 in January 1998 to 17.7:1 in January 2004, and hundreds of thousands of children are now in smaller classes. Teaching numbers are up: there are 28,500 more teachers since 1997. Teacher vacancies are down: they have been cut to 0.7 per cent. Most importantly for parents, standards are up. This year, the best ever primary results were achieved, with 53.4 per cent. of pupils achieving five or more GCSEs or GNVQs, and the highest ever number of students has been accepted at university.
	Lives have been saved and improved. Yesterday's generation is living longer; today's generation is learning better; and tomorrow's generation has a brighter future. That is not perfection, but, by any standards, it is substantial progress.

Nick Gibb: I know that this is not the direct field of the Secretary of State for Health, but he may be aware of Professor Timms' study of primary education. Professor Timms conducts huge amounts of random testing on primary schools, the results of which are not published. His conclusion is that the real improvement is only one third of what the Government claim for English in primary schools and only two thirds of what the Government claim for maths in primary schools.

John Reid: The hon. Gentleman plays a prominent role on the Education and Skills Committee, in which I think that matter will be discussed in the next 48 hours. I am not an expert, but I know that a discussion, in which he is no doubt involved, is taking place about the statistics. Importantly, nobody has said that substantial improvement has not occurred, and we are arguing about the rate of improvement. That is a legitimate argument, but that is not always reflected in some of the comments made by Conservative Front Benchers.
	Those real, practical changes are a product of our core values. The matter means something to Labour Members given our commitment to fairness, about which we feel passionately. However, the improvements are more than that, and I want to address head on the remarks made by the hon. Member for South Cambridgeshire. Those improvements are also the product of determined, driven, systematically sustained reform programmes. We know that every pound wasted on health expenditure means that someone waits in pain longer or someone dies earlier than they should do.
	We know that every pound wasted in education expenditure is a life's chance wasted for somebody, which is why we have been so committed to matching the investment of money with driving forward efficiency and reforms. I want to examine some of those reforms, which the hon. Member for South Cambridgeshire threw aside as immaterial in rather a churlish fashion. We have become more efficient. For instance, last year I announced that we would cut the number of posts in the Department of Health by 38 per cent., which involves 1,400 posts, and we are now well through that process.
	I listened carefully to the comments made by the hon. Member for South Cambridgeshire about how to run an efficient organisation. He said that the percentage of top managers should not be too high, but a little modesty and humility would not be out of place: some 3 per cent. of the NHS work force is top management, but, as far as I can see by counting the number of Front-Bench posts in the Conservative party, 53 per cent. of the Conservative parliamentary party are senior managers—Front Benchers.
	We will certainly do our best to reduce the number of Conservative MPs at the next election, but I have gone a huge way to reducing the number of people in the Department of Health by 38 per cent. We are already well into that process and a lot of money, which can be invested in the front line, has been saved. In May this year, I followed that up by announcing that we aim to halve the number of arm's-length bodies that support the NHS.
	That was the target, but I do not know whether the hon. Member for South Cambridgeshire thinks it worthwhile. Should we not have had a target? Should we have wandered around talking about the matter, without any objectives whatsoever? [Interruption.] We will reduce Department of Health staff by about 5,000, expenditure by about £500 million and the number of arm's-length bodies from 38 to 20. All that money will go into front-line care.
	Today, I have gone further, by publishing exactly how that will be done. I have published the next steps—the hon. Member for South Cambridgeshire has referred to them—in implementing the review of NHS arm's-length bodies to ensure that the NHS gets most of the money locally and an efficient central service that offers value for money. The aim of the cuts in bureaucracy that we, the Labour Government, are implementing is to ensure that every spare penny that can be spent on the front line is thus spent.
	I used the word "cuts", but there is a difference between us and the Tories. When the Tories cut health spending, they cut training places for doctors and nurses. The hon. Member for West Chelmsford (Mr. Burns) looks astounded. Let me remind him of his party's history. Those who do not know their own history are obliged to wander aimlessly in the dark, so I will enlighten him about the last Conservative Government. Under the Tories, nurse training places were cut—I wonder how much Conservative Front Benchers can recall of their slash and burn—by 25 per cent. We are constantly told that we need more GPs. Under the Conservatives, GP training places were cut by 20 per cent. And what is the deepest personal concern expressed by Conservative Front Benchers every time they stand up? It is dentistry. No one will be surprised to hear, however, that the last Conservative Government closed two dental schools, which led directly to the staff crisis that we inherited and the requirement that this Government reinstate those places.
	When the Conservatives cut, they cut training, places, front-line staff and the essential provision of care. When we restrict the budget on bureaucracy, we increase the number of nurses caring for the public—there are now 77,500 more than under the Conservatives. That is not enough, by the way, so God knows how understaffed we were when that lot left office. When we cut bureaucracy, we put it towards increases in training. Another 178 dentists per annum will be trained; more GPs than ever will be in practice and in training; and more nurses than ever will be employed by the national health service.
	Above all, we shift the emphasis and the benefit from providers to consumers—the patients themselves. Through the bulk buying of drugs, for example, we will use the power of the NHS to do what the Conservatives used to take a pride in—run an efficient business.

John Reid: Let me explain their proposals to the right hon. Gentleman. Having unleashed inefficiency in the public sector, they would do the same, if they ever got their hands on the reins of power, in the private health care sector. Let us remember the dog that did not bark, the elephant that no one mentioned and the patient's passport, which featured in the 40-minute contribution of the hon. Member for South Cambridgeshire. The Conservative Government would let anyone who could afford it buy any operation at any price from any private sector provider. Whatever the price or value, the Conservatives would provide an automatic public subsidy for such operations. That is a combination of the inefficiency of the worst 20th century subsidy-junkie thinking and the worst 19th century Conservative iniquities and inequalities. The Conservatives have managed to combine the grossest inefficiency with the grossest unfairness. They do that with so much embarrassment that they do not dare mention the policy during a major debate in the House of Commons.

Paul Burstow: That is helpful, and we would certainly acknowledge that. We look forward to seeing the detail of the Bill and working with the Government to ensure the best outcomes for children. We share the sentiment in the Queen's Speech that the welfare of children is paramount, which is made clear in the Children Act 1989. However, an alternative view seems to be advanced in some corners, not least by the Conservatives, which perhaps the interests of parents should be paramount, and that 50:50 access should be statutory, regardless of whether that is in the best interests of the child.
	The Conservatives also propose the abolition of CAFCASS. The Liberal Democrats hope that the Government—from what we have just heard, we are reassured—will take a more measured view and not simply play to the gallery, particularly a gallery that is often filled with people wearing Batman costumes. We need to ensure that the needs and interests of the child really are placed first, and if that means that both parents have 50:50 access, that is right, but if it means that the interests of the child are not central, it is not right.
	I said that education and health are inextricably linked. One area in which there is a need for rapid progress is school meals, and I note that the public health White Paper says that the Government plan a three-year review of school meal standards in England. That is a devolved matter, and one might think that school meals standards would not vary much between Scotland and England. On the face of it, one would expect them to do the same thing. On closer examination, however, there is a clear difference between Scotland and England in terms of the emphasis given in relation to nutrient guidelines, for example. In Scotland, the guidance on school meal standards talks about achieving nutrient requirements as "essential", and the overall tone is set by words like "should" and "required". Compliance in relation to nutrition is clearly expected. By contrast, England's guidance specifically says that only the regulations are compulsory and that the guidance on good practice, which includes nutrient levels, is "not required by law". The net effect of putting the nutrient recommendations at the end, pointing out that the guidance is not compulsory, and using words such as "aim" and "try" is that the specific nutrient content of school meals is marginalised.
	The Health Committee was therefore absolutely right to recommend that England should shift as soon as possible from the current food-based standards to the Scottish nutrient-based standards. The White Paper is disappointing, as it simply states that the Government will consider such a change—and, in a leisurely fashion, over the next three years. Yet good-quality, nutritious food has a key part to play both in terms of the academic attainment and performance of children and in terms of shaping healthy diet habits that will last a lifetime.

Paul Burstow: The hon. Gentleman has not so much scored a point off his hon. Friend the Chairman of the Health Committee, but has made a useful point about the fact that this issue has been hanging around for a long time. The evidence is compelling that, in England, the school meals service is suffering from poor standards and underinvestment, and that it is doing a disservice in many parts of the country, despite the noble efforts of the many catering staff who try to provide meals.
	The same delay, hesitation and further consultation in relation to the public health White Paper's proposals also applies to alcohol, smoking and food labelling. The Queen's Speech included a drugs and alcohol abuse Bill. Although that is a Home Office Bill, drug and alcohol abuse have far-reaching public health consequences, which turn up in our accident and emergency departments on Thursday, Friday and Saturday night, almost every weekend, in every city centre up and down the country. While the Liberal Democrats welcome the Government's commitment to increase the number of addicts going into treatment, we will be examining closely the details of the Government's proposals. The Government rightly talk about the need to expand treatment, yet their own figures on the numbers in treatment are misleading. They claim that 154,000 problem drug users underwent treatment in 2003–04, with an expansion in treatment places of 55 per cent. in the past five years. But if we examine the figures in more detail, we see that that was an estimate. What the National Treatment Agency for Substance Misuse goes on to say is that 125,900 individuals were "in contact with treatment". Precisely what that means is perhaps the subject for an Adjournment debate, but it suggests that the Government have claimed too much.
	In relation to tackling the alarming rise in alcohol abuse, this Bill, in line with the Government's alcohol strategy, appears to be focused on containment and punishment rather than on treatment and prevention. While we welcome a clampdown on alcohol-fuelled rowdiness, which makes such a mess of our streets, blights the lives of many in our town centres and certainly does not make those in our communities feel safer, that is only half the equation. The Government are failing to address the health consequences of Britain's binge drinking culture, which is a ticking health time bomb. There has been a 75 per cent. increase in hospital treatment for alcoholic liver disease since 1996. Alcohol-related deaths have hit a new record, and have more than doubled over the past 20 years. The Government must focus on more than just containment of the problem; they need to deal with the causes.
	Alcohol abuse among teenagers is storing up huge long-term health consequences. Every day, nine children are admitted to hospital because of alcohol- related problems—a shocking statistic. The public health White Paper was hopelessly weak on this issue. Last year, a MORI poll revealed that only 7 per cent. of men and 22 per cent. of women knew what the Government's recommended alcohol consumption was for them. Clear labelling with the numbers of units should be mandatory, and linked to a major public information initiative to publicise the recommended intake limits.
	Improving training of health care workers is also vital, particularly in primary care, as identifying and tackling alcohol dependence problems at an early stage is key. According to research by Alcohol Concern, of an average 360 hazardous and harmful drinkers who visit a GP every year, seven or fewer will have their drinking addressed by their doctor. Alcohol problems are treated more easily and more cheaply if caught early, yet only 7 per cent. of all NHS spending on alcohol misuse is spent by GPs. The Government must ensure that this Bill begins to deal with alcohol problems, and does not just deal with drug problems, and that treatment for dependency is extended to people with alcohol problems as well as those with drug problems.
	The Government's White Paper on public health also falls short in terms of protecting people from harm caused by passive smoking, and the Queen's Speech contains no Bill to do something about it. If the Secretary of State for Health admits, as he does, that passive smoking harms, that passive smoking kills and that there is no safe level of smoke, how can there be any exceptions from a ban on smoking in enclosed public places? The idea of exempting pubs that do not serve food is strange: the distinction seems to me to be born of administrative convenience rather than any real logic. Why should the health of someone eating a ploughman's lunch with a pint in a pub be more important than that of someone drinking a pint on its own?
	Guidance on the health and safety responsibilities of employers to their employees makes it very clear that current evidence of second-hand smoke doing harm and killing people is so compelling that failure to protect staff from that risk puts employers at risk of legal action. Research makes plain that ventilation systems cannot guarantee a safe working environment. I am told that as many as 10,000 air changes an hour, equivalent to a mini-tornado, blowing through a pub would be necessary to achieve anything like the necessary risk reduction. The Government's proposal to ban smoking in bar areas is unworkable and cannot ensure the safety of bar workers, let alone anyone else.
	Just where is the sense of urgency? No legislation has been announced in the Queen's Speech, and we have a timetable that is content with a three-year delay before even a partial ban on smoking in enclosed public places comes into effect. Why are the Government putting off giving a lead for two years? Despite the chief medical officer's recommendation in his 2003 report "Going Smoke Free" that NHS premises should be smoke-free by 2004, we must wait until 2006 for even that fairly modest step to be taken. Just where is the leadership?
	Then there is the question of labelling. Delaying action until 2006 and leaving everything to voluntary labelling codes fails to give consumers the information that they need to make health choices now. I hope that the Government will think again about introducing such measures earlier, not least given the clear public support that the Food Standards Agency has found.
	The Queen's Speech also states that the Government want to continue their reform of the NHS, offering more information, power and choice to patients, with equal access for all and a service that is free at the point of delivery. It is a wonderful motherhood and apple pie moment but how real is choice when so many people struggle to get on to the list of a local GP or NHS dentist in the first place? People in many areas are struggling to gain access to local GPs. According to the Audit Commission, as many as 250,000 people each year cannot find a GP because of list closures and other problems, and find themselves being assigned to a GP as a consequence.
	In its rather understated way, the Audit Commission described that as
	"a significant issue for patients."
	It certainly is a significant issue for many of our constituents. People should be able to choose their GPs and obtain care closer to their homes; they should not be allocated GPs on a basis that might entail longer journeys from where they live. Where is the choice for those 250,000 people each year? Where, indeed, is the choice for my constituents? Recently one of them, Miss Jean Duncanson, wrote to me about the difficulty that she and two of her neighbours in Elizabeth house—local authority sheltered housing—had experienced in registering with the local GP in Cheam village. Neither she nor her neighbours were able to do so; instead, they were told that they must travel by bus to practices in Sutton. My constituent felt discriminated against and let down. There was a surgery just around the corner, close to her home, to which she could not gain access.
	It is not just a question of access to GPs, however. Only last week the National Audit Office expressed concern that the new dentists' contract might result in dentists' reducing their NHS commitments further owing to lack of detail about the changes. Clearly the move away from a piecemeal, piece-rate approach makes sense, but the NAO has tapped an anxiety that needs to be addressed. The situation is indeed very worrying, given that only half the population are currently registered with NHS dentists. We need to make significant progress. The Government's dental work force review, which it took the Government over two years to publish, found that there is currently a shortfall of nearly 2,000 dentists—whole time equivalent—and that the number is set to rise to up to 5,000 by 2011. The Government say that there will be 1,000 extra dentists, but that is less than the forecast shortfall. Again, there does not seem to be enough urgency in the face of what is a massive problem of dental failure. It was inherited from the Conservatives, but it has not been addressed adequately in seven years of Labour government. Ministers are for ever talking about patient choice, but when it comes to finding a dentist millions of people throughout the country have no choice at all.
	The Secretary of State spoke of the need to move from the current waiting-time targets to an 18-week end-to-end journey time for the patient. That may be a welcome goal of which we all approve, but just when will the Government make available information on diagnostic waiting times? In June, when the Secretary of State made a statement on the NHS improvement plan, he accepted that diagnostic waiting lists were the NHS's hidden waiting lists. Many of my constituents feel that they are stuck and lost in limbo, waiting for diagnostic appointments and the right scans so that they have the diagnosis that will enable them to secure the treatment that they need. It cannot be right for the information not to be collected and published, when that would allow everyone to see just how well their own NHS trust is performing and would help us to see how waiting times can be cut.
	People are waiting for months in hospitals across the country for vital computerised tomography, magnetic resonance imaging and other diagnostic scans. As I have said, the Government have announced that they will cut the waiting times, but they themselves do not know how many patients are waiting for diagnostic tests or how long they are waiting; and they have failed to introduce a system for the routine collection of data from hospitals which would provide a clear picture. Without reliable and accurate data, how on earth do the Government expect anyone to plan properly to reduce diagnostic waiting times in the first place?
	The hon. Member for South Cambridgeshire (Mr. Lansley) raised the question of my party's commitment to hypothecation of national insurance to fund the NHS. While not wishing to talk about his own policy on many matters, he was quite happy to talk about ours. I too am happy to say a little more about our policy. I certainly want to make it clear that we are committed to matching the Government's spending plans in full, and to achieving the staffing improvements that have been proposed for the next four or five years.
	The aim, first and foremost, of our proposal for an NHS contribution is to make clearer to people just how much they are spending on the NHS from their taxes, as an aid to accountability and transparency. We are committed to hypothecating national insurance for that purpose. The figures given by the hon. Gentleman are the sort that one should look at closely before foolishly stepping into the big hole that he was trying to dig for me. If he writes to me setting out the basis of his calculations and assumptions, I shall be more than happy to write back explaining where he is confused and wrong about our policy. Perhaps when he writes to me he will also explain how the Conservatives justify spending £1.2 billion to fund a policy that used to be called the patient passport policy, but is now a policy without a name—but with a deadweight cost of £1.2 billion for the NHS, without a single extra operation being performed as a result. If the hon. Gentleman is prepared to write to me about that, I shall be more than prepared to respond to him further on other matters.
	The Queen's Speech also referred to the Government's intention to continue pre-legislative scrutiny of the draft Mental Health Bill. I have had an opportunity, as I am sure others have, to dip into some of the evidence sessions—to hear some of what has been said, and to read many of the transcripts. It appears from the evidence taken to date by a Joint Committee that has examined the draft Bill in detail that it has a long way to go before being anywhere near acceptable to those with an interest in mental health services and problems. It strikes one as a Bill that was drafted in the Home Office rather than one that was conceived to meet the needs of people with mental health problems. That concern is shared by the Law Society, by nearly all—if not all—mental health charities, and by professional groups.
	The Government have performed a unique act. They have managed to construct a coalition of interested parties across the board, all of whom say one thing: that the Bill is the wrong Bill. Compulsion is not the right way in which to deal with mental health problems. Indeed, Cliff Prior, chief executive and chairman of the mental health charity Rethink, said the following in giving evidence to the Committee:
	"When this long drawn out process began in 1999, the government's stated aim was to reduce compulsion. It was told that its plans would do just the opposite. Despite a few concessions, nothing has been done to address this fundamental flaw."
	Indeed, I understand that when, during some of the visits carried out so far, people were asked whether they preferred prison or a mental health institution, many opted for prison because there is a guaranteed release date and the guarantee of spending a certain amount of time each day in the fresh air. Those two guarantees do not seem to apply to people who languish under restraint in mental health institutions.
	Finally, the Queen's Speech talks about health care free at the point of delivery. We Liberal Democrats are entirely signed up to that principle, but if it is indeed to be free and available at the point of delivery, why, for example, does a person with advanced dementia who requires catheterisation, help with feeding—even peg feeding—and intimate personal care have to pay for such care? How can that be fair? The Queen's Speech should have included a Bill to end the arbitrary divide between health care, nursing care and personal care—a divide that is defined more by who provides the care than by the nature of the care itself.
	This is a Home Office Queen's Speech and a programme with one date in mind: polling day. Health and education are the poor relations in the legislative programme that this Queen's Speech sets out. That programme places fear ahead of hope, and we Liberal Democrats will continue to provide an effective opposition to it.

Barry Sheerman: It gives me great pleasure to contribute to this debate. Most of my remarks will focus on education, but as is our privilege in this debate, I shall start by commenting on the broader context of the Queen's Speech. We do indeed have the opportunity to take a longer view, and the comments of the Opposition spokesmen—both of whom dealt mainly with health—perhaps reflect the fact that we are getting quite close to a general election that everyone seems to think will take place next May.
	Time and again, my constituents come to my advice surgeries, or write to me, to say how much the health system has improved for them, and genuinely to thank me as a Labour Member of Parliament. No reasonably fair-minded person can doubt that consumer satisfaction with the health service has gone up astronomically in the past seven years. The picture with education is also very encouraging. When the Education and Skills Committee recently went to Norway, the permanent secretary in Norway's department of education said, "I am perhaps going to make you feel uncomfortable. Normally, you seek information on these visits, but I want to ask you some questions. We spend far more on education than you do, but the reforms that you have introduced seem to be producing outstanding results and pushing up standards. We want to learn how to do what you're doing, because in Norway we spend far more per head on education."
	In the context of the real world, I am now going to be slightly unkind about the Government, even though I honestly feel that there has been a great increase in the quality of health care and a great improvement in many aspects of the education service. I have always been interested in preventive health care. As most people who know me realise, I am not a health expert, but early in my career in the House, I and others formed a group called the Parliamentary Advisory Council for Transport Safety. We campaigned for seat belt legislation, and for many other reforms that have saved countless lives over the years during which we have energetically pursued these issues. In that time, PACTS has made a real difference, and I welcome the measures on road safety in the Queen's Speech, because they will save many lives.
	It is important to strike a balance on these issues. We all know that the safest way to travel is by aeroplane, the second safest is by train, and the most dangerous is by bicycle or motorcycle. So when there is an accident on the railway, let us please see it in that context. Before spending billions of pounds of taxpayers' money on saving a tiny number of lives a year, we should consider how many people are killed on our roads every day.
	I am sorry that the Secretary of State for Health is not in his place, because if he were I would say to him in public what I have said to him in private. I came to this House to protect people in the workplace, and the evidence shows that passive smoking not only kills but causes dreadful ill health and means a much shorter life for the many people who have to breathe in other people's smoke while at work. I have always believed that if we approach this issue in terms of protecting workers' health there is an indisputable case for rapid change, so it grieves me that no measure has been introduced. We have a White Paper, we have had the discussion and the arguments have been made. There is no reason why the Queen's Speech should not have included a commitment to enabling this House to introduce a Bill similar to those introduced in Norway and in the Republic of Ireland a year ago. Two of our European Union colleagues have introduced such legislation, and it is already working very successfully in both those countries.
	Let us consider the deep shame of what happened to the miners. It was not until the mid-1960s that legislation was introduced to protect miners from breathing in the filth of the mine debris and dust that caused so many dreadful diseases. What a shameful record! Yet now we are lingering—waiting to introduce a measure that everybody knows needs to be introduced. The White Paper is a step in the right direction, but it gets a critical point wrong. If we believe in protecting workers' health, we cannot exclude 20 per cent. of establishments from the smoke-free provision. Are we going to say that workers in those establishments should not have to care about their health, and neither do we? What sort of legislation would that lead to?
	I have a warning for the Secretary of State for Health and for those on the Front Bench. Why should this be a party political measure? I believe that when a Bill on this subject comes before the House of Commons—it is a pity that that will not be sooner rather than later—on a free vote, there will be an overwhelming majority for a measure along the lines of the Irish legislation. That is my clear view, and if I were lucky enough to secure a slot for a private Member's Bill this week, I would introduce such legislation myself, and hope that the Government would give it fair wind. That gets that particular concern off my chest.
	I will say in passing that I have been a long-term advocate and passionate believer in a system of identity cards. I cannot believe some of things that I have heard about the identity card scheme—I see my colleague on the Select Committee, the hon. Member for Bognor Regis and Littlehampton (Mr. Gibb) disagreeing with me, as I would expect. If we are going to have a decent system of law and order in this country and be able to catch the criminals that plague the lives of some of my constituents, identity cards are crucial. I am not convinced by the arguments of Conservative and Liberal Democrat Members against the scheme.
	Having now alienated most hon. Members with my views on what should and should not have been in the Queen's Speech, may I quickly run through two or three concerns about the long-term implications of aspects of the education proposals? I have already said that I believe that there has been a profound positive improvement in the quality of education in our country, but what worries me most is that, as Chairman of the Education and Skills Committee, I am aware of areas where we are not applying the views that the Government have enunciated.
	For example, we as a Government believe in evidence-based policy—we hear Ministers telling us that all the time. That is a very good rule: finding evidence and introducing policies on the basis of it. No Government or Administration get it right all the time, but since 1997 this Government have introduced many interesting innovative measures and, even more importantly, put substantial resources behind them. There has never been as much money invested in education in this country as has been invested since 1997. That is good news.
	However, I have to say to the Secretary of State and the Government that they must evaluate their measures carefully and respond quickly. Some will work and some will not; some will become something of a disaster. As Chairman of the Select Committee, I know about individual learning accounts and attempts to establish a UK e-university. Those were brave experiments and good ideas, but they did not work out in practice. We have to dust ourselves off, evaluate what went wrong and then get it right next time. If there is a general systemic failure across a range of issues—perhaps in some of the public-private partnerships that the Department has implemented—we have to learn from it. The Select Committee's role, at its best, is to advise the Government how to put problems right.
	Sure Start policy is another important issue. I have been a devoted supporter of it, and all the research and modelling from the best think-tanks shows that the best possible spend that can be made is on early years education. That is where the best value for money is. Stimulating children's imagination and giving them the chance to change their lives very early on is important, as is giving parents the opportunity to stimulate their children in the right way. I am wholly convinced by that, but the early research into Sure Start seems to show that only about 28 per cent. of it is effective. The Secretary of State needs to be aware that very good programmes sometimes yield results that are not 100 per cent. effective. Sure Start-type programmes need to be modified and built on in the future.
	On the other hand, I can say that our policy on free nursery places has proved magnificent. The recent research of Cathy Silver and her team showed how excellent pre-school experience is. What a fantastic investment it has been for the taxpayer. It is important to get the balance right and understand the need to monitor the evidence closely and respond quickly to modify policy.
	The Government will probably not like to hear another criticism, but the Queen's Speech refers to Ofsted and the need to modify it. It is my Committee's job to hold Ofsted, as well as the Government and the Department, to account, and Ofsted has appeared regularly before our Committee.
	We have consistently argued for lighter-touch inspection. I am delighted that the Government are introducing such a system, although I have some concerns about using lighter-touch inspection across the piece as a rule. Some schools—perhaps between 10 and 20 per cent., although I do not know the exact figure—may need a much longer inspection. They may need a longer inspection, but they do not need inspectors to come in, tell them what is wrong with the school and then they walk away without providing any help to sort out the problems and get the system right. That has always been my criticism of Ofsted: too often, it goes into a school setting, tells the school that it is not performing in a range of areas and then walks away.
	When we press the chief inspector of schools, David Bell, and ask him, "But surely if you find that a number of schools in one town or city all have a similar problem"—in other words, systemic failure—"do you mean to say that you would not pick up the phone to the LEA's director and say 'you've got some problems here, and it's not just one school—it's a cluster of schools—and if you don't do something about it, when we evaluate you, as the LEA, you will have problems?"' The two things are not really in sync. Yes, Ofsted evaluates LEAs; yes, it evaluates schools, but it fails in the systemic evaluation of schools in certain areas, and the Government must be very careful about that problem, especially when it is linked to my second point.
	My second point is that, in the Queen's Speech, we have yet another step towards schools becoming more independent and more in control of their own destinies than ever before. That journey has been going for a long time, but I tell the Secretary of State for Education and Skills that it is perilous. We took the Select Committee to look at the system in New Zealand, where a Labour Government gave absolute independence to their schools 10 years ago. There are no local education authorities and there is no council interference—local councils no longer have an education remit or role—but the people who had experienced that system for some time found it very difficult. The independence was such that, where systemic failure was found, there was no one between the Department of Education and what was happening in the schools, so it became extremely difficult to achieve systemic change in the education system and process.

Michael Fabricant: The hon. Gentleman is raising an interesting issue. Does he not think that a sort of comparison can be made between education and health? The point that he makes about systemic problems is almost a study of epidemiology. Is the problem in New Zealand not so much that the schools are independent but that there is no proper study of what might be going wrong? Does he not think that, if there was greater independence for schools in the UK, combined with a better Ofsted system similar to that which he espoused earlier, one could get the best of both worlds?

Kali Mountford: I thank my hon. Friend and good neighbour for giving way on this point. In his analysis and the experience that we have in west Yorkshire, what contribution does he feel can be made to bringing out the best qualities of each school and each individual by schools collaborating across a whole area? They can contribute to what he says about knitting across the system of post-16 education.

Stephen Dorrell: I shall come to that in due course. Before I do so, I want to respond to the charges made from the Dispatch Box. The first was that we would extend charging—an accusation that is always made in the run-up to an election. The second was that we would cut NHS spending, blind to the fact that no Conservative Government have cut NHS spending during their period office and that the shadow Chancellor made it crystal clear that we intend to carry through the spending plans published by the Government.
	The third and most absurd proposition that Labour spokesmen advance is that the Conservative party is not committed to the principles of the NHS. As always when I hear that charge, I get out my calculator to remind myself of how many years there have been since the foundation of the NHS in 1948 and of how many years there have been of Conservative government and of Labour government during that period. When I do so, I find that the Conservatives have been in government for 35 of those 56 years.
	I invite the House and, more importantly, the voters and anyone who might be interested in the arguments to reflect on the fact that if it were true, as Labour spokesmen have said consistently throughout those 56 years, that the Conservative party was not committed to developing the principle of the NHS, would it not have been likely that at some point during its 35 years in government it might have done something about it?
	When the Secretary of State presents what I have called his Dr. Jekyll personality, he is realistic; I do not agree with everything he says, but we can have a sensible debate. When he presents the other side of his personality, it is a sign that an election is coming. When Labour spokesmen advance an analysis of Tory threats to the health service, it is one of the most sure bell-wethers of British politics that an election is not far around the corner. I guess that that confirms what most of us know.
	The reality, and by far the most important point that emerged from the Secretary of State's speech, for which I give him some credit, is that to be committed to the principle of the NHS is to be committed to making difficult decisions about its evolution. Those who are genuinely committed to the development of the service and those who are genuinely committed to the development of maintained schools and the broader education sector are not and cannot at the same time be committed to no change in those sectors. The difficult argument—the interesting argument—involves the nature of the changes that need to be made to ensure that the commitment that we all have to the principles that lie behind them is delivered in reality in the years ahead, and that we continue to see regular improvements for children and patients.
	I should like to address the nature of the changes that are taking place in our key public services, the rate at which the Government are introducing changes and the faltering nature, as I see it, of the process of change in health and education services.
	It is one of the oddities of Queen's Speeches under this Government that they provide us, in the sense of a Kremlinologist, with a barometer that tells us about the current state of the relationship between the Prime Minister and the Chancellor of the Exchequer. It is—[Interruption.] The Secretary of State for Education and Skills should listen. I shall develop the argument, and the right hon. Gentleman will be hard put to deny its different elements. When we read the Queen's Speech, we find that the areas in which the Government will act are those where the Prime Minister and the Chancellor agree. The areas where the Government are introducing some generally fine-sounding words but nothing very radical are those where the Prime Minister would like to do more but the Chancellor will not let him. That is the argument around the evolution of public services that lies at the heart of the Government.
	We all know what the Prime Minister's instincts are on this subject, and he loses no opportunity to tell us. We remember him telling us that he bears the scars on his back of those who oppose reform in the public services. We saw some of those responsible for inflicting those scars sitting behind the Secretary of State for Health.
	The Prime Minister railed famously against the forces of conservatism, which in the press release was conveniently spelt with a capital C. The reality is that many of the most difficult opponents that the Prime Minister faces in the political arena are in his own party. They are relentless opponents of change within the public services.
	The Prime Minister and I would number the Secretaries of State for Education and Skills and for Health among his friends on this subject. They understand the need for radical reform, but they are repeatedly blocked by internal opposition within the Labour party, led by the Chancellor. The most prominent example, foundation hospitals, arose in the previous Session, when the then Secretary of State for Health wanted to return to an agenda that we set out in the 1990s to create more independent and flexible management for major hospitals to allow them to respond more effectively to local needs—the needs of their patients and the priorities of the local communities that they are there to serve. It is well documented that the then Health Secretary repeatedly lost arguments with the Treasury and the Chancellor of the Exchequer. The Bill on foundation hospitals that was finally introduced did not deliver the measure of reform required to make the health service the flexible, responsive and efficient service that we all want in the coming years. It did not provide local hospital management with the capacity to evolve their own local employment terms for staff and gave them an absurdly politicised management structure. It did not give them freedom to borrow and thus access the resources that they need to develop their hospitals. The Chancellor obstructed reform by the Prime Minister and the then Health Secretary—now Cabinet supremo for policy development and winning elections and, I am sorry to tell the Secretary of State for Education and Skills, heir apparent.

Stephen Dorrell: Indeed. The Treasury obstructed the drive to reform. I believe that the agenda for reform of the public services lies at the heart of political debate and will be the key domestic priority in the years ahead, so I approach the Queen's Speech with a sinking sense of disappointment. It is clear that the Prime Minister has largely left the field, and there are no major proposals that will continue the reform of health care and education that is needed if we are to deliver our objectives for those services.
	That does not mean, however, that there is nothing of value in the Queen's Speech. I shall begin my examination of the proposals for the year ahead by looking at a measure that is not in the Queen's Speech because, I suspect, it does not need to be. In the middle of our party conference this year, the Government published a paper that I was pleased to welcome in a later question to the Prime Minister. He would not accept this description—indeed, he did not do so—but the paper outlines the Government's plan to reintroduce GP fundholding. I am delighted, however, that they aim to do so. They have, of course, changed the name—they call it practice-based commissioning, but they give the game away in the opening line of the paper:
	"There is nothing new in the concept of Practice Based Commissioning."
	You can say that again! From April 2005, GP practices can, if they so wish, be given indicative commissioning budgets, which is exactly what GP fundholding was about. I take a particular interest in the subject, because it was the first major issue for which I took ministerial responsibility when I was appointed junior Minister in the Department of Health in 1990. I read the document and almost wrote to the Secretary of State in the belief that I could offer my services as someone who has been here before. There are a number of things that I would have worded differently. The Government have fallen into a number of traps, which could have been avoided if they had been prepared to learn some of the lessons of experience. We could have made quicker progress towards a shared objective.

Michael Fabricant: I am grateful to my right hon. Friend for giving way a second time. Does he also recall that fundholding GP practices were able to perform minor surgery, thereby taking the burden off cottage hospitals and larger district hospitals? That was abandoned, too, causing the problems that I raised earlier with the Secretary of State for Health.

Stephen Dorrell: I am grateful to my hon. Friend for setting himself a fairly ambitious target. I hope that the Government will embrace that £600 million target; if they do not do so, they will need to explain why.
	One of the oddities about the Government's paper on this matter is their statement that if a practice achieves savings as a result of innovative commissioning—that is clearly the idea of the exercise—only 50 per cent. of the savings achieved will be available for the benefit of its patients. I do not understand why there should be a 50 per cent. limit, because its effect is that the other 50 per cent. of the savings achieved by innovative commissioning in one practice area will go to the benefit of patients in an unrelated practice area.
	I do not see the logic of that approach. If a practice achieves savings and more efficient commissioning for its own patients, surely the people who should get the benefit of that resource, which will be more efficiently used, are the patients of that practice. I would be grateful if somebody explained to me why 50 per cent. of the savings should disappear into the ether. Why should not 100 per cent. be available to improve the health care of the patients of the practice in question?
	In developing the idea of practice-based commissioning, I hope that the Secretary of State for Education will convey to the Secretary of State for Health my heartfelt good wishes for him in his no doubt upcoming battles with the Chancellor of the Exchequer and the Chancellor's friends on the Back Benches. The Health Secretary will have to do better this year than he did last year on foundation hospitals if we are to secure the real benefits that will be available for health service patients and if this idea is to be allowed to run properly. I wish to turn now to the Education Secretary's responsibilities.

Charles Clarke: Before the right hon. Gentleman moves on, I remind the House that he said that he would comment on the patient's passport. I hope that he will do so before he moves on to education, as I think the whole House would be interested in his analysis of the policy proposal.

Stephen Dorrell: I am sure that the whole House is waiting for that with bated breath, but hon. Members are probably waiting with even more bated breath for me to sit down so that they can make their own contributions. I would not wish to deny the Education Secretary my thoughts on his departmental responsibilities, so I shall move on, if I may.
	Turning to the relaunch of what I would describe as the city technology college programme, I am grateful to the Education Secretary for his hospitality, as he very kindly gave me a dinner in the company of 200 or 300 others at a promotion of his city academies programme. I was glad to go the city academies dinner, as I thought that it felt very like dinners that I attended before 1997 to promote the development of what used to be called, as hon. Members will remember, city technology colleges. Indeed, so like city technology colleges are the academies that the Secretary of State quoted in his departmental plan of July the example of a very successful academy. I do not know the details, but I am prepared to believe that this is an admirable story, and I would like to read it to the House:
	"Walsall Academy opened in September 2003 . . . Its sponsors are Thomas Telford School in Shropshire—one of the original City Technology Colleges, with an outstanding record of pupil achievement and innovation in the application of information technology . . . in partnership with the Mercers' Company, a City of London charitable livery company".
	Members should bear it in mind that Walsall academy opened in September 2003, so this record is startling. Since it opened, it
	"has already raised the proportion of students gaining five good GCSEs from 13 per cent. in 2001 to 49 per cent. in 2003. There are now ten times as many students applying for a place at the school than before—with 608 applications for September 2004 compared to just 57 students in"
	the predecessor school's last intake.
	That is a huge success story, and I give the Secretary of State for Education and Skills credit for promoting the city academy programme, which is a relaunched city technology college programme. However, the same comment applies: if it is such a good idea—it is plainly a good idea—why did it have a seven-year sabbatical? Why could the reinvigorated Government post-1997 not follow through on the idea, instead of taking a great historical loop around a dead end? It is to the credit of the Prime Minister and the Secretary of State for Education and Skills that, if the newspapers are to be believed—I think that they are largely to be believed on this subject—they won their battle with the Chancellor on the target of 200 city academies. The policy is good, and I hope that that target is achieved.

Charles Clarke: Will the right hon. Gentleman accept that the lineal descendent of the CTC is the specialist school? Some 60 per cent. of secondary schools in the country are specialist schools and the growth has been consistent. When I became Secretary of State, one of my first steps was to remove the cap, so that every secondary school might become a specialist school and achieve the dramatic improvements in results to which the right hon. Gentleman refers. His criticism simply has no foundation.

Stephen Dorrell: No; I do not accept that independent schools, which I shall discuss in a moment, are the lineal descendents of the CTCs. The key thing about the CTCs is that they introduced major private sector partners, which the city academy programme is also designed to do. I am surprised that the Secretary of State for Education and Skills is so bashful about his policy, which is very good.
	I shall read out another element of the policy:
	"Academies are promoted and managed by independent sponsors . . . They are free to innovate as they wish, within the law and requirements on admissions"—
	I shall have something to say about that in a moment—
	"in order to transform standards in areas that have been persistently ill-served in the past."
	That is precisely what CTCs were designed to do.
	"Sponsors contribute up to £2 million towards the initial capital cost".
	One again, the policy is a straight lift from the CTC programme. However, it is welcome, and the Secretary of State for Education and Skills should not be so bashful.

Stephen Dorrell: The hon. Gentleman has focused on one policy—city academies. He has forgotten what I have said about foundation hospitals and fundholding and has not yet heard what I am about to say about independent specialist schools, which are not, as the Secretary of State for Education and Skills has proposed, the lineal descendents of CTCs. The parentage of the independent specialist schools is much closer to grant maintained schools, which is another programme that the Government have abolished. In the rubric that I have quoted, the Government have brought out of retirement all the arguments that were used to develop the grant maintained schools programme, to which the hon. Member for Huddersfield has referred.
	The hon. Member for Huddersfield is worried about the implications of the policy, and he is not entirely signed up to the policy of the Secretary of State for Education and Skills. I am on the side of the Secretary of State for Education and Skills, who has got a good idea. I am concerned, however, that he, like the previous Secretary of State for Health, will be unable to carry this policy past Members such as the hon. Member for Huddersfield, with all respect to him, and, indeed, the Chancellor of the Exchequer. Winning the battle for independent specialist schools to ensure that they have genuine per capita funding and are allowed to own their own buildings and to employ their own staff is absolutely central to the success of the Secretary of State's policy. I regret that he has already, in a pre-emptive cringe to the Treasury, had to concede the politically correct line on the law on admissions.
	Perhaps when the Secretary of State winds up he will be able to explain to the House how we distinguish between the dictionary words "aptitude" and "ability". We have specialist schools in science, music and other subjects, which is very good, and they are allowed to select up to 10 per cent. of pupils on the basis of aptitude, not ability. When I briefly did the Front-Bench job of my hon. Friend the Member for Westmorland and Lonsdale (Mr. Collins) at the beginning of the 1997 Parliament, I devoted a lot of time, with the present Home Secretary, to teasing out how we distinguish tests for aptitude from tests for ability. I look forward to hearing the Secretary of State, with his superior intellect, clarify that.

Stephen Dorrell: As my hon. Friend the Member for Westmorland and Lonsdale is indicating disagreement with that representation of our policy, I feel under no compulsion to agree with it.
	The Secretary of State is on to a genuinely good idea as regards city academies and independent schools, but I am worried about his pre-emptive cringe to the Treasury. I am also worried, as the Health Secretary has now rejoined us, about the track record of his predecessor in getting similar policies through the Treasury in the guise of foundation hospitals.
	I cited three specific examples and I could add others. The key issue is how we reform the public services to deliver the commitments that are shared by Members across the House, including the hon. Member for Huddersfield, with whom I disagree on methods but agree on objectives. Whether in health care or education, the objective should be high-quality services that are available on the basis of need. It is to the Prime Minister's credit that when he makes speeches he appears to be clear that who provides the service is not the key issue. Indeed, he seems to think that there is an advantage in plural provision: let a thousand flowers bloom; let a number of different approaches be tried.
	The key factor in our concept of public services is equitable access. That is a genuinely attractive vision for the future of public services that sets out to break down the accursed distinction between those who "go private" and those who rely on the state sector. We want to provide equitable access to a variety of institutions, both public and private, with access to a single system rather than allowing education and health care provision to continue to develop as two separate systems. Separate development is not an idea with a happy historical provenance. There is a dawning realisation in some parts of the Labour party—although none at all, from what I can make out, in the Liberal Democrat party—of the importance of that idea, but the problem is that every time we come to the crunch those with that dawning realisation appear to lose their battle.
	We all know that the Queen's Speech is likely to be the last of the Parliament. I have no doubt that the Prime Minister and the Chancellor can keep the show on the road between now and the general election. However, the contradictions between the approach of the Secretary of State for Health and that of the Secretary of State for Education and Skills become clearer daily. The most important question at the next general election will be whether we continue with a team whose members do not agree about the most fundamental issue that faces Britain in the years ahead or accept the logic of the Prime Minister's occasional rhetoric on the subject, and elect a Government who can do something about it rather than simply talk.

Madam Deputy Speaker: Order. Several hon. Members hope to catch my eye. I remind hon. Members that the debate is time limited—perhaps they will bear that in mind when they make their contributions.

Laura Moffatt: I am pleased to follow the right hon. Member for Charnwood (Mr. Dorrell) because I listened carefully to his comments and I want to respond to some of his assertions.
	I want to deal with both aspects of the debate—education and health—because I firmly believe that few other subjects affect our constituents more. They are greatly involved in them and feel that they will affect their families in future. We should therefore take any action in these areas, especially in connection with the Queen's Speech, extremely seriously.
	If hon. Members visited Crawley—which they are welcome to do—it would be obvious to them that the education landscape had been transformed. One can enter the town from the south and look at all the new build. Astonishingly, we have three new secondary schools, one of which is completely new, and not rebuilt. People in the part of town where it is situated had been calling for that for many years. We have state-of-the-art special schools that deliver education to children and young people of hugely varying abilities in a way that we did not believe was possible. We also have new-build primary provision and an explosion in nursery care. The landscape is therefore very different from that of 1997.
	I want to ensure that we understand how the difference came about. There is no magic to it. Crawley was once a new town, and the new build of 60 years ago had not been renewed or refurbished. The only way we could get money for education was by selling a bit of playing field: that was the only way that any schools managed to get rebuilt. However, in 1997 there was an explosion in building, and new confidence in education provision in Crawley.
	I say to the right hon. Member for Charnwood that we could hold great debates about approaches to education, but without the resources we would simply be wasting our time. The aims and objectives of our teachers are now properly supported, which means that we can produce the sort of building that they want to work in and children find attractive. Circumstances are now completely different, which allows children to raise their game at school. They now have a different attitude towards staying on. They desperately want to do that, and I believe that education maintenance grants have made an enormous contribution to that change.
	Let me consider the aspects of the Queen's Speech that are relevant to education. I was delighted to hear from my hon. Friend the Member for Huddersfield (Mr. Sheerman), the Chairman of the Education and Skills Committee, as he spoke for many Members—certainly those who have been corresponding and raising the issue of having a light touch where we need to, while retaining an overarching authority that can get the family of schools working together, sharing experiences and also sharing what often cannot be done in one school. Hearing my hon. Friend speak in that way was music to the ears of people in Crawley, and we will certainly watch the Bill with great interest as it makes its way through Parliament. I will be an active supporter of it.
	I have said something about education, which I believe has gone extremely well in Crawley, and few of us would argue that the reforms and the resources have not produced something that we can be incredibly proud of. The election of the Labour Government in 1997 was key to that. However, I now turn to an issue that has been quite difficult to deal with: modernisation, and ensuring that our health services can react to today's needs. Again, few of us would argue that enormous strides have not been made in the development of our health services.
	Again I am thinking about what is happening in my own town, and considering the development of primary care. I firmly believe that bringing our GP practices to work together and think about the whole town, rather than just the little bit of it that each one happens to be serving, has been hugely beneficial to us all. Our GPs come together to discuss how we can ensure that health care is delivered throughout the town equally and co-operatively, not in the sense that one practice may be able to save some money and reinvest in some other way. I firmly believe that this has completely changed how GPs function.
	This has not been an easy process—indeed, it has been a difficult one—but the ability to share information and expertise has borne an enormous amount of fruit. That will always be there for us now. We have encouraged people to work co-operatively, and that is a learned experience. People have learned to do it, and to respect their colleagues.

Nick Gibb: It is a pleasure to follow the hon. Member for Crawley (Laura Moffatt), who is a fellow west Sussex Member of Parliament. I agree fully with her call for a non-partisan debate by Members of Parliament on public services and the health service in particular. I endorse her comments on that particularly.
	The Chairman of the Select Committee made some comments about identity cards, on which I want to touch briefly before moving on to education policy. If the Government go ahead with the introduction of identity cards, I think that they will regret it deeply. It would be a huge extension of state power into the lives of ordinary people. ID cards always start off as popular, and then become hugely unpopular—they started off very popular in Australia, and then almost brought down the Government at one stage. Identity cards pose a danger, especially with today's technology, of aggregating in one place, around one identification number, all the personal information that is held by the state. That gives rise to a real danger that an unauthorised official will have access to information to which he is not entitled.
	Neither do I believe that identity cards will work to deliver that which is claimed for them. They must be carried all the time to be effective—

Nick Gibb: I will obey your strictures, Madam Deputy Speaker.
	The Queen's Speech talks of the high importance that the Government attach to educational opportunities enabling all individuals to realise their full potential. Who could disagree with that? I wonder, however, whether the Government are doing enough to achieve that aim.
	On a number of occasions, I have raised in the House the issues of phonics in the teaching of reading in primary schools, the teaching of multiplication tables by rote—which I do not think happens in many primary schools—and mixed-ability teaching in secondary schools. I have raised those issues not just because they are important in themselves, although they are. Ours is one of the worst literacy rates in the developed world, with 23 per cent. of adults unable to read a simple instruction on the side of an aspirin bottle, 17 per cent. of 11-year-olds leaving primary school for secondary school still unable to read properly, and 37 per cent. of 11-year-olds leaving primary school unable to write properly—and they will never catch up, or recover from that bad start to their secondary school education.
	Employers complain that school leavers do not have a basic knowledge of maths or English. According to the most authoritative international survey of education systems around the world, the TIMSS—the third international mathematics and science study—our state education system comes a poor 20th among those in 41 developed countries. The parents of one in four state pupils now think it necessary for their child to have private tuition, particularly in maths.
	As I said, I have not raised those issues just because they are important in themselves. I have done so because they relate to the political and philosophical debate about who runs our state-sector public services. The hon. Member for Crawley touched on that when she said that Members of Parliament had a right to challenge experts on the conduct of the provision of public services. My question is this: is it the professional bodies who run and determine policy in our public services, or is it elected politicians? Does the Association of Chief Police Officers decide policing policy, or does the Home Secretary? Does the NHS Confederation or the Secretary of State for Health decide health policy? Do the education academics in our universities decide education policy, or does the Secretary of State for Education and Skills?
	The public are quite clear about who is responsible. They understand our constitution, and they believe that the politicians are responsible. When things go wrong, they blame the politicians. Politicians, however, actually have very little say in key policy areas in education, health and policing. I believe that that is one of the main reasons why Governments of both parties have failed to deliver the improvements and reforms that were promised so faithfully. As a result, people have become very disillusioned with politicians and the whole political process.
	When I raised the issue of mixed-ability teaching with the Secretary of State and the Minister for School Standards, I pointed out that 60 per cent. of all lessons in comprehensive schools took place in mixed-ability classes. That came as a surprise to many, but the figures were from Ofsted and had emerged in parliamentary questions.
	The Minister's initial response was that there was no evidence that teaching in a mixed-ability class was any less effective than streaming or setting according to ability. Labour's 1997 manifesto, however, contained an explicit promise to increase the amount of setting. It said:
	"Children are not all of the same ability, nor do they learn at the same speed. That means 'setting' children in classes to maximise progress, for the benefit of high-fliers and slower learners alike. The focus must be on levelling up, not levelling down."
	To the Minister's credit, he was happy to engage in a constructive discussion with me on the academic evidence that he had been given in the Department. The key document is a report by Laura Sukhnandan and Barbara Lee from the National Foundation for Educational Research. It is a publicly available document. The West Sussex director of education has also used it as a basis for our discussions about streaming in schools in that area. It is a summary of the literature on streaming and setting by ability, and it concludes that there was insufficient evidence that setting resulted in higher educational achievement, and that setting had a negative impact on those belonging to particular social groups.
	On examining the report in more detail and looking at the underlying research that it claims to summarise, it is clear that it is tendentious and does not accurately reflect that research. It says that research by Kulik and Kulik, two American academics, concludes that
	"although students in streamed settings outperform students in mixed ability settings by a small amount, the differences are not significantly different."
	But reading Kulik and Kulik's research reveals that they say that only in respect of cases where the curriculum is not tailored to the particular ability level. The curriculum should of course be tailored to the particular ability level when setting is introduced, and Kulik and Kulik concluded that when it is, very significant gains are made in educational attainment at the top level, strong gains are made in the middle, and there is a neutral result—in other words, no loss—at the bottom. They also concluded that those at the bottom experience a small increase in self-esteem, and that the very bright pupils at the top experience a small decrease in self-esteem as they are confronted with competition for the first time.
	On further reading the research of the proponents of mixed-ability teaching—the key proponent is R.E. Slavin—it is clear that their main motivation is social equality rather than higher educational standards. I have no complaint about those who are motivated by that point of view, which is a perfectly respectable one to hold. Slavin believes that one breaks down social division by deliberately mixing different abilities in a classroom, but in my view, that method perpetuates social division. It damages the educational achievement of those from lower socio-economic groups in particular, who do not have the background to counter the poor educational achievement that results from mixed-ability teaching. So the consequence of such teaching is the opposite of what Slavin wants: social division is perpetuated, rather than ended. I strongly believe that Members who look at the research will conclude that setting results in significantly higher educational achievement, even if common sense does not already lead them to that conclusion.
	During my friendly discussions with the Minister, and in answer to a parliamentary question, the Department for Education and Skills offered its next defence of the status quo. It accepted that overall, 60 per cent. of lessons take place in mixed-ability classes, but it argued that there is setting in the core subjects and that the 60 per cent. figure includes lots of peripheral, non-core subjects. So I tabled some more parliamentary questions to test that argument. They were answered by Ofsted, which showed that there was setting in 80 per cent. of maths lessons—a core subject. That supports the Government's contention, but it still means that that there is no setting in one in five maths lessons in our comprehensives. Only 54 per cent. of lessons in English—another core subject—are in sets, which means that nearly half of all such lessons in our secondary schools take place in mixed-ability classes. There is setting in only 20 per cent. of history lessons and 36 per cent. of geography lessons. That knocks on the head the argument that the 60 per cent. figure relates to non-core subjects; rather, it relates to the core, principal subjects.
	Once that argument had been conceded, the next response was that that this is a matter for heads and teachers, rather than for Ministers. That brings me back to the core question. Should the decision about whether to stream secondary schoolchildren be a matter for the professions, or for elected politicians? That is an important philosophical issue, which we should consider. If every secondary school in this country were the envy of the world, if our schools filled parents with confidence, and if education were not the number two political concern in almost every opinion survey, I would agree that these matters should be left to teachers and heads. But if it is clear that one of the root causes of underperformance in our schools is mixed-ability teaching—it is a matter for debate, but I believe that it is—Ministers and Parliament have a right and a duty to intervene, or at the very least to engage in the debate with the professions about that particular policy.
	Speaking as someone who was a chartered accountant by profession before I entered the House, I know that we were continually being told by the Department of Trade and Industry how to go about doing our job as auditors. We were told how to audit and what to put in companies' accounts, but I never felt that my professionalism was being undermined. Is not our children's education more important than the presentation of a profit figure for a company?
	I think that the Government agree with me on this matter. Earlier this month the Minister for School Standards spoke to the annual meeting of the Girls Schools Association and reported the "startling" findings of a four-year study conducted by academics at Cambridge university into the differences in educational achievement of boys and girls. Revealing the evidence from that study to the world, he said that the research
	"looked at a co-educational comprehensive school where single-sex teaching was used in subjects where gender is sometimes seen as influencing underperformance, such as languages for boys and maths for girls."
	He continued:
	"The number of boys who got five good GCSEs went up from 68 per cent. in 1997 to 81 per cent. in 2004. The number of girls went up from 68 per cent. in 1997 to 82 per cent. in 2004."
	By segregating pupils into boys-only classes for languages and girls-only classes for maths and by arranging the seating into girl-boy, girl-boy throughout the classroom for all other subjects, those results were achieved. That is what this particular co-ed comprehensive did during this experiment over a particular period, and the results were startling with increases from 61 per cent. in 1997 to 81 or 82 per cent. by 2004. The reasons for the success were discussed in interviews and it was felt that pupils suffered from fewer distractions and that boys and girls did not feel the need to show off to each other.
	Those remarks are very revealing for a number of reasons. First, it shows that there is an enormous amount of underachievement in our secondary schools. If making simple changes in classroom configuration can bring about such improvements in educational attainment in GCSEs, it is clear that in most schools where those changes have not been made—clearly the overwhelming majority of schools—pupils are performing way below their potential.
	That research and the speech made by the Minister for School Standards directly contradict the Government's claims that secondary education in this country is doing fine. The Government cite surveys such as those conducted by the Programme for International Student Assessment to prove that everything is fine in our secondary schools, which they follow up by saying that they would still like to do a little bit more. I believe that the research I have cited shows a huge amount of underachievement in Britain's secondary schools. It also shows that the move towards co-education was not based on any research or evidence that better results could be achieved. Too much of what happens in education is based on assertion rather than evidence-based policy making. That must be changed and I hope that the Government will ensure that policy changes are based on evidence rather than on the assertion of education academics.
	The most revealing aspect of the speech by the Minister for School Standards is the acknowledgement that politicians can be involved in the debate about how the teaching profession goes about its business. He was directly engaging in debate about classroom configuration, so if he can engage with the issue of gender in classroom configuration, why cannot he engage on the issue of ability grouping? Why should setting be a matter for teachers, heads and the profession while gender can be influenced by politicians? The truth is that there is no distinction and the Minister was right to engage in the debate about gender, as he would be right to engage publicly in the debate about setting.
	The next issue then becomes how much notice schools take of the research and the Minister's comments on it. If the research were replicated and the startling results repeated, would it not be a disgrace if it were not instantly taken up by every co-ed comprehensive in Britain in order to make huge improvements in educational attainment? What will be the result if that does not happen and the assertion-based policy emanating from education academics and disseminated by teacher training colleges continues to ignore that research, just as the research on mixed-ability teaching has been ignored? What should hon. Members do about it? What should the Government do about it? More importantly, what can the public, particularly the parents, do about it? When those questions have been considered, we should apply the answers to mixed-ability teaching and phonics versus whole language methods in the teaching of reading in primary schools.
	I hope that all hon. Members who are interested in education will start to address some of the real issues that cause underperformance in our schools, put aside the ideology and the party pre-positioning and have the confidence, as democratically elected politicians, to challenge the comfortable and complacent educational orthodoxies that, for 30 or 40 years, have led to the gradual decline of our state education system.

Kali Mountford: I should like to take up where the hon. Member for Bognor Regis and Littlehampton (Mr. Gibb) left off, to some extent, because I found his speech absolutely fascinating. It behoves hon. Members who did not hear his comments, some of which illuminated the whole education debate, to read them later. I, for one, will study hard what he said because there is great merit in extending the argument in education to consider issues that we do not traditionally look at as politicians and tend to leave to the teaching professions.
	The hon. Gentleman's contribution was very worthwhile indeed, and it pointed me towards some other issues. Year in, year out, we debate the attainment of young people in secondary education and their ability to do more, and the outcry is always that we must have lowered standards. There is no acceptance of the fact that there is hidden, untapped potential, but the findings that he points to reveal an untapped potential that we ought to reach and show that there is great merit in looking at ways to reach it that we may not have looked at previously.
	I hope that the answer is as simple as streaming. In my constituency, where streaming is common, school results are extremely good. I recently visited one school that, when we took office in 1997, already enjoyed high attainment on which it would be difficult to improve. The main thrust of my speech will be about, for example, the healthy schools initiative, and one thing that I noticed on my visit was the fact that it was a healthy school. Although its pupils were criticised for their exam results that year, the fact that the school's high standards of achievement have improved time and again shows that that it is an outstandingly good school.

Kelvin Hopkins: My hon. Friend is making a very good speech with which I agree. However, does she not agree that a great danger for mothers is drinking while they are pregnant? That brings a high risk of foetal damage that affects children for the rest of their lives. We have not paid sufficient attention to that issue so far.

Kali Mountford: My hon. Friend is absolutely right. Babies might be underweight at birth due to drug abuse or under-nourishment. Under-nourishment in babies often goes alongside their mother's drinking because that can have an effect on their mother's normal nutrition and diet. He is right to point out the huge impact of a mother's drinking on her unborn child.
	I would like a campaign to encourage all pregnant mums to be more careful without having to enter into the debate of whether we are being a nanny state and failing to accept that all people have individuality and their own responsibilities. Of course we must strike a balance between the two. However, if a mother acts irresponsibly, what is our responsibility? Should we let her continue her actions, or intervene when her child is born, which used to happen a lot, but is now not encouraged?

Kelvin Hopkins: My hon. Friend is absolutely correct that we have the right to make decisions about our own lives, but when behaviour such as passive smoking affects others—perhaps a foetus—choices are being made about other people's freedom.

Kali Mountford: I was coming on to that point, and it is where the rights and responsibilities argument is the crux of the matter. We must take responsibility on behalf of the community to care for such unborn children, so the most obvious thing to do is to educate mothers about the effects of their behaviour so that they can choose not to behave in such a way. It is more difficult to treat babies who are sickly due to their mothers' alcohol or drug abuse, under-nourishment, or any other behaviour than to encourage mothers not to behave in such a way.
	It is now almost unknown for mums to smoke during pregnancy, so that campaign has started to hit home. Any pregnant mum who lights up in the street or a bus shelter is frowned upon or causes people to raise an eyebrow. Everyone would have a word with such a person and say, "You know, this really isn't on." However, other health messages have not been conveyed to such an extent that we will collectively encourage and admonish young mums for other behaviours. I would prefer to encourage them, because if people are constantly admonished by society, it becomes more difficult to change behaviour. If we encourage and inform people, we empower them to change what they are doing.
	The whole of this health debate, which is extremely welcome, is centred on setting individual freedoms against our rights and responsibilities. The Government have the responsibility to act on behalf of everyone, because we all pay for the results of people's behaviour in the end. We pay through our own health when we breathe the smoke of others. We pay if we pick up the pieces for someone whose health has failed because of alcohol abuse. If a person is completely out of control in the street, we pick up the pieces and pick up the tab, so we take on extra responsibilities.
	The right place to start to address the matter is in our schools, which takes me back to the healthy schools initiative. I was extremely impressed by teachers' enthusiasm for the scheme in a school that I visited. They were initially cynical about it and thought that it was another gimmick, or a ploy to engage them so that it would look as though people were doing something. However, they told me that when they got into the scheme, started to push the agenda along and realised their power to make a difference, their attitude to it changed, as did that of the young people in the school. The young people started to learn about more than just eating five portions of fruit and vegetables a day. I assure the House that I do that, despite my appearance—[Hon. Members: "You look very nice".] I suggest that hon. Members stop there.
	We should consider not only what people eat, but the more intimate aspects of people's lives that some parents would perhaps prefer us not to discuss in detail. People have got used to the idea of sex education in schools and are beginning to accept that even quite young children can understand complicated messages about sexual relationships and what they mean. The messages rightly focus on the nature of love in a relationship and the responsibility that two people have to each other. However, we need to go much further and talk about the dangers of sexual activity, but not in a frightening way. We cannot say, "No. Don't do any of that. It's not a nice thing to do, so don't do it at all because you'll get sick." Children are not going to believe us if every time they try anything that we say they should not do, they find it fun. Even if they do believe us about the risks, they will carry on because the fun outweighs the message.
	We have to get around that problem in an intelligent way. We need to reach young people in a way that makes sense to them, which is not by hectoring and lecturing them. We also need to provide support if they become frightened by the message. The problem is that if they think that they have contracted a disease, instead of telling us about it, as is often the case, they might withdraw into themselves because of the fear they encounter. They would rather run away from the problem.
	In my view, young people are certainly too young to engage in sexual activity if they are in secondary school, but we know that they do. They will not admit that that is what they are doing because they think that they will be told off. They say, "Me Dad'll kill me. You can't tell me Mum. She'll go mad", but it is better that Mum and Dad go mad than some time down the line infertility sets in, which happens to some young women with Chlamydia. Other long-term health problems could also set in. Irreversible damage can be done, but they cannot envisage that at that young age and cannot believe that that could be the consequence of their actions.
	We need to find ways to get the message over. Sometimes that needs to be done on a one-to-one basis. The healthy schools initiative is an important part of that, but it needs more investment, especially for school counselling services. Proper places have to be set up. The ones that I visited in my constituency are nice places to be in. They are in the colours that create an environment in which young people feel comfortable and at home. They do not feel threatened by those places. However, there are always two or three other chairs in case someone wants to bring their Mum or Dad along. I find that young people would rather bring another 13 or 14-year-old along with them. We need to get around the fears about bringing Mum or Dad along. It should be a partnership across the community so that the feeling of safety that they need to tell us about their problems is engendered in the school.
	I applaud the schools in my constituency that have embarked on the healthy schools initiative because it has made a difference to some aspects of health. What they have dealt with is laudable. I have no complaint about educating people about not smoking, not drinking, eating properly and having proper exercise. All those things are good, but we are still a little squeamish about saying to young people, "These are the things that could happen to you if you don't protect yourself."
	The House might think it a little mad of me to reveal this, but I sent two 30-year-olds into my constituency to buy condoms. I thought that a woman of my advanced years would not be credible, and perhaps I should have found someone younger, but those people went for me. They could not find them on display anywhere. They went into chemists, the local pharmacy, pubs and supermarkets and found that they had to ask someone for them. I should explain that it is a semi-rural constituency, and there is only one smallish supermarket that has them in stock, which says something about the supply in areas such as mine.It was of great concern to me that when they came back they said that they could not find one place where they could pick up condoms, take them to a counter and pay for them. What are we saying to young people about the availability of one of the best methods of protecting themselves? We are making it extremely difficult for them to protect themselves. I put the matter to the primary care trust in my constituency and asked it what is being done. We have a good teenage pregnancy strategy, and that obviously goes a long way to dealing with some of the sexual health problems that come from sexual encounters, especially if the core message is the use of condoms.
	It seemed to me that the sexual programme was not complete. In some places, counselling services are provided by GPs on top of what is available at a minority of schools. There seems to be a need to make more available the very means that young people require to protect themselves. If they cannot pick up a packet of condoms from the counter, they have to go to somebody and ask for help. That may be somebody whom they trust—for example, the school nurse, their local GP or someone at one of the new centres that is being set up around some of the new GP practices, with the help of the PCT. However, with all the new services that are available, young people have to pluck up the courage to ask.
	I send out a plea not only to the manufacturers and distributors of condoms but to all retailers as well to think again about their policies about where they place condoms. The reason I have been given about their placing of these products is the risk of pilfering. As a result, they make them difficult to pick up. They may consider pilfering a high price to pay but it is a higher price to see some young people whose lives are devastated by an early sexual encounter. My plea may not be best placed with the Secretary of State, but I hope that my words are heard by those outside the House who can help us in a collaboration between medicine producers, condom producers, all pharmacies, all suppliers and all the efforts that we are putting in through the House, local education authorities and health services so that people's lives are not endangered in future and people can have the future that they richly deserve.

Michael Fabricant: There are times when it is a real pleasure to be in the Chamber. The previous two contributions were especially powerful and extremely interesting. Although the hon. Member for Colne Valley (Kari Mountford) said that she was not addressing her comments so much to the Secretary of State, I am sure that he was listening and will have heard the hon. Lady's wise words.
	I applaud all those who work in the national health service and in education. As right hon. and hon. Members have said, those people work hard for themselves and, more importantly, for those whom they serve—children, students, parents and patients. We should never forget the contribution that they make and, in many instances, what they have to put up with. It is a great shame that the Secretary of State for Education and Skills has just left the Chamber because I was about to talk about the things that teachers have to put up with, but no doubt the Minister for Children, Young People and Families will be taking copious notes and will pass them on to the right hon. Gentleman.
	I shall take up three particular issues. The first is medical research, which affects health and science, so it straddles both health and education. It also straddles the responsibilities of the Home Office, because I shall talk about a problem in my constituency involving animal rights activists. Secondly, I shall speak about the real problem of there being a two-tier health service. In an earlier intervention, I think that the Secretary of State for Health accepted that it exists, although he deplores it. Thirdly, I shall speak about an issue that the hon. Member for Colne Valley raised, which is smoking and health. I suspect that we share similar views.
	In my constituency, there is a farm that breeds guinea pigs primarily for medical research.

Michael Fabricant: Indeed. It is, however, a serious issue. I asked the Under-Secretary of State for the Home Department, the hon. Member for Don Valley (Caroline Flint) how many animals are used for research on things such as household products. It turns out that 99.9916 per cent. of all research on animals is done for scientific purposes, primarily for the benefit of people suffering from diseases and to develop new vaccines and treatments in the health sector.
	As I said, villagers in my constituency have been terrorised for five years. It is not just the people who breed the guinea pigs who are affected but newsagents and people who run a tennis club, where a member was threatened. I very much welcome the proposal in the Queen's Speech to introduce Home Office legislation to try and control the problem. However, existing laws such as the Police and Criminal Evidence Act 1984 and the Public Order Act 1986—I could list more legislation, but I shall not do so—enable the police to control the activities of animal rights terrorists. It is right to call them terrorists because they terrorise people. The police, however, cannot be everywhere, and I am concerned that the new legislation will not be sufficient to control the activities of animal rights extremists either because there are gaps in the legislation—the devil is always in the detail—or because there are not enough police officers. I note, incidentally, the Conservative commitment to increase the number of police in Staffordshire by 670, which would certainly make a real difference.
	Establishments that breed and supply animals such as guinea pigs are required to comply with standards of housing, welfare and care in codes of practice that specifically address the needs of breeding animals. The codes require that suitable environmental conditions are provided for different species and for different stages of development. Temperature, ventilation, and light and noise levels must be appropriate. The astonishing thing is that if the animal rights extremists were successful, the guinea pigs would have to be imported from countries that do not have such controls. It is important that animals are supplied from within the United Kingdom, because we have strict controls on the way in which they are bred.
	Recently, I attended a Royal Society conference to hear about the genome project, with which the Department of Health is very much involved. The project has analysed every single gene in the human body, but researchers do not know precisely what individual genes and combination of genes do. Apparently, 80 per cent. of human genes are similar to guinea pig genes, so there is a clear overlap in the research needed to benefit mankind.
	I am speaking about diseases that at present are incurable, such as diabetes, where we can treat only the symptoms. There is a real possibility of a cure for diabetes, whereby the islets of Langerhans could be injected into the pancreas and people would no longer need to take insulin on a regular basis. I intended to speak at greater length on the subject, but I know that I would be trying the patience of Mr. Deputy Speaker and I would never wish to do that.
	Let me move on to a second issue. In an intervention I raised with the Secretary of State for Health the matter of my constituent who had a heart attack and found, after going to hospital, that he needed an angiogram. He was told that it would take three months before he could get on to a waiting list, and he would then have to wait a further three or four months for his angiogram. The angiogram was necessary to determine what damage there had been to the blood vessels supplying his heart and whether there was any damage to his heart itself. Waiting and worrying for such a long time might have brought on a second heart attack. He was advised that if he chose to have it done privately, he could have the angiogram in the next few days. So he chose to have the angiogram done privately and it cost him £1,800 because he did not have private health insurance.
	I can give another example of someone I know in Wales, who had a tumour behind his eye. Again, he was advised to have an examination done privately, so that the diagnosis could be made quickly and treatment could start sooner. That cost him in the region of £2,000, and again he had to pay out of his own pocket. Last year there were 250,000 such procedures, where people were told that if they wanted to be diagnosed or treated quickly, they would have to pay for it themselves. It does not behove those on the Government Front Bench to say that it is the Conservatives who want a two-tier health system. We do not, but the sad fact is that we have a two-tier health system already.

Michael Fabricant: It is fallacious to say, as the hon. Gentleman claims, that demand will always be met by any health service in any country. I can tell him that there certainly are waiting lists in France, despite the fact that, as he rightly points out, more money is spent on the health service there—considerably more than in the United Kingdom.
	I was with someone last night from Iceland, which has a population of only 280,000. He explained to me that they have a voucher system. I am not advocating that—it is certainly not Conservative party policy—but it is interesting. In Iceland one has to pay £3 every time one sees a doctor. That teaches people to respect doctors' appointments. All the rest is subsidised by the state. Once one has seen the doctor and is referred, the treatment is free. But there are waiting lists even in Iceland, as there are in France.
	I do not think any Government will ever provide sufficient money for people to be treated instantly, but there is a huge discrepancy between the types of treatment available. We need honesty among all parties on questions such as where a private health care system is or is not appropriate. I was rather pleased with what the Secretary of State for Health said. He ended up by espousing much of what the Conservative Government were saying in 1996 and 1997—that there is a role for private health care and there should be that choice. As the right hon. Gentleman said to me after my intervention, the choice should be whether one wants to have the treatment privately for convenience or whether one does not mind waiting for the NHS. When it comes to a matter of life and death, however, or at least of being treated in the NHS within a reasonable time, it is wrong for NHS people to say "Look, you will have to go to private health care."
	The person whom I mentioned was also told that he would not be put on the waiting list for a good three months. The fact that that happens time and again demonstrates how the waiting list figures are fiddled. If somebody is not included on the waiting list, the overall time that they have waited is not counted in the total waiting time. That is a real problem that I know both main parties would wish to address, but we have to be honest about this matter, and I feel that we are not at times.
	Let me now move on very briskly to smoking and health. I am disappointed that the Queen's Speech does not announce legislation on the control of smoking. Many hon. Members on both sides of the House— I suspect that they are on the Opposition Benches in particular—will disagree, and say that there should be freedom of choice as to whether people smoke. I argue, however, that there should also be freedom to decide whether one can breathe clean air. The hon. Member for Colne Valley rightly pointed out that individuals must exercise responsibility, as well as the Government.
	We have a duty of care, and there is no doubt whatever that smoking kills. I could be cruel and say that if somebody continues to smoke despite an excellent television and radio campaign by the Department of Health, it is up to them to make the decision. If the activity kills others through passive smoking, however, it has to be wrong, and I do not understand how people can argue that the state should not intervene in this instance. Indeed, I well remember that, when I worked in broadcasting, it was a Conservative Government who introduced legislation through the Independent Broadcasting Authority, as it then was, to ban cigarette advertising on radio and television. So there is nothing inconsistent with Conservative policy in saying that that approach should be extended elsewhere.
	The issue needs to be addressed; indeed, it is a popular issue as well. Recently, research was undertaken to determine whether people would oppose a proposal to introduce anti-smoking laws in this country. Some 54 per cent. of respondents said that they strongly supported a smoke-free law, as they called it, while a further 35 per cent. said that they would tend to support such law if they knew more about the detail. In other words, 89 per cent. of the population believe that it is right that people should be allowed to eat in restaurants or work in an environment where they are not forced to breathe in other people's smoke. I believe that it is right and proper for any Government to introduce legislation of this type.
	There are those who say that such legislation would not work, but that is plain nonsense. Studies in the United States have shown that banning smoking in restaurants has either a neutral or a beneficial effect on the economy and, indeed, increases tourist business. We would not be doing anything new in introducing such measures. There is smoke control in Australia, Canada, Iceland, Ireland, the Netherlands and the states of California and Minnesota. Anybody who has visited New York City will know that it has very strict rules on smoking, but they certainly do not stop people going to restaurants.
	I am going to stop speaking now because of your advice, Mr. Deputy Speaker, that I could not speak on my main subject, which would have been animal rights activists. I welcome the Home Secretary's legislation, although the devil will be in the detail, but I believe that it could be better enforced with the 40,000 extra police officers that are being promised from a Conservative Administration.

Brian Jenkins: It is a pleasure to participate in the Queen's Speech debate. It is also a pleasure to follow my next door neighbour, the hon. Member for Lichfield (Michael Fabricant). Ironically and coincidentally, we are both covered by the same PCT, but he thinks the glass half empty, whereas I think it half full.
	I have looked at my constituency in the context of the measures in a number of Queen's Speeches, and I shall outline one or two areas into which we have put a lot of money for new buildings, new equipment and extra staff, leading to falling waiting lists for treatment. I shall consider the sickness service first, rather than overall health.
	I was first elected to this House in 1996. Not many months afterwards, the front page of my local paper reported that one of my constituents had had to remortgage his home to pay for his heart bypass operation—a shocking story. However, not one similar story has appeared in the past five years. The system had fallen into an awful state, and it has taken money, and the involvement of the professionals who work unstintingly in the health service, to get us to our present position.
	We now treat more people better and faster, and people who have gone through the system tell me about the state that it is in today. Our difficulty is to catch the urban myths and legends, because people reiterate stories about things that took place some 10 years ago. When my right hon. Friend the Secretary of State for Health visits the Sir Robert Peel hospital, Tamworth, tomorrow, he will see an excellent little hospital, run by a professional team who have provided new services and innovations.
	In this afternoon's debate, one or two hon. Members have mentioned the private-public gap. They seem to think that the private initiatives in health come only from one side. I keep telling people this: when I visit my GP, which I do fairly regularly, I park my car in a car park that is private and belongs to the private buildings of a privately run practice. The GPs own the buildings. When I walk in and I see the girl or woman behind the counter—it is a very nice place, and I am treated professionally—she is an employee of the practice. I then see a doctor who is a contractor to the health service.
	So far I have not seen or been in one publicly owned facility. When my GP writes out a prescription, it is on a form printed by a private practice. I take it down to a local shop, where the shopkeeper gets me some tablets made by a private drug company—and we think that we have a problem with private involvement in the health service! The NHS has always been privately provided and publicly funded. It is about time we got away from the hang-up of opposing any private involvement in the health service.
	My right hon. Friend the Secretary of State for Health knows that the ambulance service in Staffordshire is second to none. We are currently using extra facilities in our ambulance service. When an ambulance attends a location, paramedics can treat people on the spot; there is often no need to take people to hospital in an ambulance. Admittance to hospital by ambulance occurs at a far higher rate than admittance of people who turn up by themselves. I hope that hospitals will stop being blocked and resources wasted in that manner. That is a priority in Staffordshire today, and it works well. The hospitals that serve my area are very good.
	I am amazed when I hear people debate hospital-acquired infections in the public arena. They discuss the matter with great sincerity, but it is a pity that they have not read the Public Accounts Committee report. The PAC went through the matter religiously, and we identified the problems.
	I do not want to say, "Privatise hospital cleaning," because that would not advance the situation one iota. We know that all hospitals should be kept clean and free from debris and dust. That is not the problem, because what looks like the cleanest hospital in the world can still have an infection problem. Across the world, different infections spring up in different countries. The key point is the culture of people not washing their hands and transmitting the infection from patient to patient.

Brian Jenkins: My hon. Friend is welcome to say that, but I could not possibly comment.
	After months of trials to find the best antibacterial agent, we now have a system whereby doctors always carry syringes at their sides so that they can wash their hands as they go from patient to patient. Everyone who enters a ward now uses that facility, which may be the best option for reducing infection rates in our hospitals.
	I want to move on to the broader concepts of health. Many years ago, I took health to mean stopping people getting sick, but one of the reasons why our primary care trust has spent so much time and effort is that people go out into the community and visit patients at home—mental health patients or elderly patients, for example—to ensure that they stay healthy. We should move that up the agenda, because when people are treated at home they must be kept in reasonable conditions.
	In January 1985 I was involved in a local council by-election, and I went to a row of old people's bungalows and knocked on the first door. The person who answered had his coat, hat and scarf on, so I said, "I'm terribly sorry, sir—I shan't be a moment," because I thought that he was going out. I asked him my question and moved on to the second house, where again, the occupant had his hat, coat and scarf on. I thought that the two of them must be going out together, so I said, "Shan't be a moment, sir," asked him my question, and moved on. When the third person came to the door with his hat, coat and scarf on, I thought, "There must a be bus around here somewhere." Then it dawned on me. I asked him if he was going out, and he said no—he was sitting like that by his fire, which was switched down to one bar. He had to choose between keeping the house warm or eating. We had turned into a miserable society.
	Thankfully, when we introduced the £200 winter allowance, those people could switch the other bar of the fire on, to keep the place warm as well as eating. Our warm front programme should be applauded for putting millions of pounds into targeting those vulnerable people to ensure that they double glaze and insulate their homes to keep them warm in the cold months. If that is not done, the health service has to pick up the tab, and it is a losing battle on both fronts.
	Sure Start is a brilliant programme. The other week I went along to one in my area, where mothers were being shown how to prepare food and cook. I hope that my right hon. Friend the Health Secretary will speak to his pal the Education Secretary and ask him to get food preparation and cooking back into our schools where it belongs, because children, male and female, leave school with no concept of food preparation other than reaching for a can and a tin-opener, and given the high levels of sugar and salt in those cans, it is no surprise that they become obese.
	When my right hon. Friend talks to the Education Secretary, will he also congratulate him from me, and from Tamworth, and tell him to keep up the good work? There is a lot done, but a lot more to do. We have some excellent schools with good and dedicated professionals who are turning out children with higher qualifications and more aspirations than we have ever had in our town. Our secondary schools work together in concert so that children can be transferred from one sixth form to another, because one specialises in music while another specialises in sport or in science.
	Nevertheless, I enter a plea to the Education Secretary on behalf of Staffordshire. If we are to send money to each individual school—an idea that would find favour with certain Members, including me—will he ensure that the formula employed is not the malign and discredited one used by the Department for Education and Skills, but the one used by the Office of the Deputy Prime Minister, which shows us where deprivation and poverty are? In Staffordshire we suffer from pockets of deprivation that a wealthy county masks. I look forward to the response on that subject.
	More youngsters than ever now enter higher education and training. Will my right hon. Friend the Secretary of State for Education and Skills, who is about to resume his seat, answer a question? The Opposition amendment states that they are appalled that we have taken no action to abolish tuition fees. After research and consultation with universities, will my right hon. Friend tell us how the universities would make up the shortfall, and how many United Kingdom students would find that the place that they believed was allocated to them had disappeared because the universities could not fund it? Parents and youngsters would like to know that, because it would present them with a choice about the direction to take.
	My right hon. Friend the Secretary of State for Health knows that when I was first elected in 1996, there was mass unemployment, and an alarming and increasing number of people were registered as disabled. I realised that the two went hand in hand. A person who is unemployed and feeling depressed will look for an option, and disability can be such an option. A hard core of individuals believe that they are actually disabled and cannot work any more—and they would find it difficult to get back into the work force. Employment can play as great a role as keeping homes warm in the health of a nation. We should therefore consider it seriously.
	Today, more people than ever are in work. We have eliminated long-term youth unemployment but we still need more trained people. After years of boom and bust in engineering, fathers advise their sons and daughters not to go into it. Although some of us believe that engineering and manufacturing still have a part to play in creating this country's wealth, we struggle to get people into education and training for them and to view industry and manufacturing as a career opportunity.
	There are some excellent small firms in my constituency. They approach me regularly and bemoan the fact that they cannot get the trained skilled personnel that they need. They cannot get our bright youngsters, who have been siphoned off to do courses at university that will not provide them with a future, when they could have been trained in skilled work in our factories. Small firms acknowledge the Government's role in maintaining low interest rates and stability, but they feel lonely and a little unloved. They do not believe that they are the Government's favourite sons. Can we please send them a few warm words to ensure that they know that we acknowledge the major contribution that they make to our country?
	I shall not discuss identity cards, or you would rule me out of order, Mr. Deputy Speaker. I simply say that much more work must be done to explain exactly what we would do with them.
	The Opposition amendment calls for effective choice. Given our record over the past seven years, I believe that our people must have the information to make an effective choice. When they do that, I know that they will stick to the Government, who have done so much but have much more to do.

Alistair Burt: I welcome the chance to participate again in an important debate on the Queen's Speech. I want to make a couple of general comments before focusing on the issues of the day.
	As a former Minister with responsibility for people with disabilities, I welcome and thank the Government for the further steps to reduce discrimination against disabled people. As the Minister for Children, Young People and Families knows, being a Minister for disabled people is one of the best jobs in Government. It provides a unique opportunity to see life from a rather different perspective and to learn from that. Spending any time with disabled people tells us of a number of frustrations and distractions, which can be dealt with only by the change of attitude that is at the heart of anti-discrimination legislation. I stress that that change of attitude in society is much the most important thing.
	Before dealing with the topics of the day, may I say a brief word in response to the Home Secretary's attempt to persuade us all that the policies and targets that he advocates will lead to a safer Britain? I might be forgiven for feeling that that has a rather hollow ring in North-East Bedfordshire, particularly around Yarl's Wood, as last week the Prison Service ombudsman produced a report that specifically blamed ill thought through policies and the pursuit of unachievable targets for the near disaster that engulfed the Yarl's Wood removal centre on 14 February 2002.
	The Government's attempt then to deal with security issues set in train a series of consequences that cost more than £100 million and which, but for the individual heroism of many people on the night, could have led to scores of deaths. I was disappointed that the Home Secretary could not come to the Dispatch Box to introduce that report personally and to answer questions as to which parts of this particular policy fiasco have contributed most to the concept of a safer Britain, but come to the Dispatch Box in due course he will.
	I give my wholehearted support to the amendment moved by my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) and contribute to the debate by again reinforcing the commitment to the that my colleagues and I share. My father was a GP for nearly 50 years and my brother is a consultant anaesthetist at St. Thomas'. My wife and I have no private health insurance and our children were born in the NHS facilities at the wonderful Fairfield hospital in Bury, so let no one say there is a lack of commitment to the health service on this side of the House.
	The big issues for my constituents are not addressed by the Queen's Speech or by what the Secretary of State had to say, despite his valiant efforts. My constituency, like a number of others in the south-east, faces an enormous housing increase: there will be 80,000 more houses in Bedfordshire over the next 25 years. Our facilities and infrastructure are already stretched, so how will they cope with this pressure on resources? We are stretched in relation to GPs: 330 are needed in Hertfordshire and Bedfordshire over the next three years, even before all this building takes place. That has not been addressed and I am worried about it, as are my constituents.
	On education, the Government's determination, as stated in the Queen's Speech, to ensure that children fulfil all their talents and abilities is devoid of meaning without ensuring the right environment for teaching and learning. Despite the Government's avowed emphasis on education, is it not, after seven years, a matter of shame for them that one in three 11-year-olds leaves school unable to write properly, 1 million children play truant every year and there is an assault on a teacher every seven minutes? If those issues are not addressed, the Government's rhetoric is as nothing.
	In my constituency, parents of children in special schools feel threatened. The Government's pressure towards an inclusionist policy, which has its good points, runs the risk, by being pushed too far, of going beyond the aspiration of parents and the assessments of professionals in those schools, thus changing their character, not necessarily in the interests of each and every child. Those interests must be paramount. I urge the Secretary of State to include in the education Bill some measure on the further protection of special schools.
	Schools in my constituency also tend to feel that the Government are all talk in terms of their commitment improve children's sport in schools. In 2001, the lottery—not the Government—set up the fund for sport and physical education with a balance of more than £0.5 billion. Schools attempted to access it, but got caught up in extraordinary bureaucracy to such an extent that by the middle of this year only £10 million of the £0.5 billion committed in 2001 had been spent.
	Sharnbrook upper school in my constituency, with its excellent head teacher Peter Barnard, was caught up in this. He reckons that it has cost him some 18 months—nearly £40,000 worth of time—to seek to access £250,000 from the fund. A Government who were really committed to sport in schools would have sorted out such nonsense a long time ago. How much more the Queen's Speech could have achieved if it had recognised the people's priorities of cleaner hospitals and school discipline, and made people truly feel safer, not by frightening them, and putting forward half-baked policies and targets, but by matching our commitment for 40,000 more police over the next eight years.
	I want to turn to my substantive remarks on chlamydia. I am sorry that the hon. Member for Colne Valley (Kali Mountford) is not in her place, because enjoyed what she said, which was helpful and significant. I am not sure whether an education Bill will examine this issue, as it may not be the place to do so, but can I urge the Government to conduct a serious review of sex education in schools? The information given to the House last week by the Secretary of State for Health that perhaps one in 10 sexually active women under the age of 25 is infected with chlamydia is perhaps one of the saddest statistics of our age. For whatever reason, we have surely failed our children if the demystification of sex over the past 40 years or so has resulted in the sort of unhappiness that comes from the picking-up of a sexually transmitted disease or infection.
	A fascinating exchange took place last week on BBC television's "Question Time". A questioner from the audience asked about the rate of increase of chlamydia and whether we were therefore losing the battle for safe sex. Bishop James Jones of Liverpool then questioned the conventional wisdom that nothing much could done about young people having sex, by saying that growing numbers of young people of faith backgrounds—Christian, Jewish and Muslim—wanted their faith reservations on early sex to be backed up by a society that encouraged and supported them if they wished to say no. The Liverpool audience gave the bishop strong support for such a view. That is worth exploring further, and it is a matter of great urgency to do so.
	First, there is plenty of evidence that whatever we have been doing up to now has not really worked well enough. Secondly, the impact of such diseases and infections on young people can be catastrophic, and it is unacceptable to leave things as they are. Thirdly, to take a different tack, the cost to the NHS both of dealing with such diseases and infections, and future infertility, is great and growing. Fourthly, we must be honest about how we have got to where we are. There is a significant danger of the polarisation of views on this sensitive topic not being in anyone's best interest.
	As a practising Christian, I reject a view that sex education is wrong, and that the more that is learned, the more harmful it is. Dutch and Swedish experience suggests the contrary. But such education should be considered in the context of the teaching of relationships and values accompanying the learning of the technicalities. Equally, those who condemn abstinence education out of hand should examine it again, not because it is the only answer, but because children are not uniform, and different teaching and different ideas will strike young people differently.
	There is a further point. Forty years ago, those who spoke from a position of faith—often Christian—on these matters, and who tried to make an abstinence case, were often derided. They were, they were told, backward, against feminism, morally judgmental, and representing a finger-wagging authoritarian God whose nature was to condemn. Whether or not some took such a view, there was no evidence then available of where a society changing its moral and commercial attitudes to sex would go. The arguments could therefore rage in some form of vacuum.
	But now things are different. There is evidence of genuine harm being done to our young people. Anecdotal stories of peer pressure to have sex early, encouraged by a far more sexualised society, can now be accompanied by information on rises in disease and infection and, as Bishop Jones said on "Question Time", sheer unhappiness.
	That is not what we want for our children, and what we may be able to cope with as adults may not be right for them. I suggest to the House that the Christian response might now be seen in a different light. God gave his rules for our lives not because he wishes to condemn but because he loves us, and wants us to fulfil all that we can be. He warns against things that might hurt us. There is no condemnation.
	Contrary to popular myth, the overwhelming characteristic is not that we are unabridged successes working in a context of self-righteousness but that we have all messed up, and we all have experience of a loving God reaching out to pick us up out of our mess and take us somewhere better. Let us adopt a balanced approach to sex education. Children must have knowledge—not to give them that would be to leave them unarmed in the world—but it must be put in a context of value and relationships. Those who feel unready, and do not want to take a relationship that far, should be encouraged to feel that saying no is powerful and right. Good medical back-up and professional services should also be available to deal with physical issues unambiguously and unashamedly. Let us not assume that, with such an approach, we cannot aspire to alter behaviour, and to enhance children's sense of self-esteem and self-respect in the avoidance of sexual activity.
	We are so open about almost everything else to do with sex, but listening to youngsters on that programme and reading their comments on the BBC website makes one appreciate how hit-and-miss our sex education really is. Let us pick up the best ideas in the world. Let us talk to faith groups about their contributions. Let us also recognise a worry among people that years of licence, while helping us come to terms with many sexual matters and avoid misery, have also caused unwitting harm to others. I hope that the Government will consider an urgent review of sex education in the current Session.

Richard Taylor: I find myself in a very privileged position in debates such as this. I can congratulate the Government when I think they are getting things right, and warn them when I think they are getting things wrong.
	I was going to spend the first half of my speech congratulating the Secretary of State for Health, but he has had his enjoyment for today, and time is limited. Tribute has already been paid to improvements in cardiac surgery and cancer care; I add my tribute to the improvements in consultation, the forming of overview and scrutiny committees, patient forums and the independent reconfiguration panel, and above all the paper "Keeping the NHS local", which paints a good picture for the future of patient and public involvement.
	Let me now make some rather more critical comments. As the Secretary of State knows, I welcome the public health White Paper. I particularly welcome its emphasis on sexual health, which has been discussed many times. It reinforces warnings of the risks of unprotected sex, which have faded into the background since the first HIV scares. The current goal is that by 2008 waiting time for an appointment in a genito-urinary clinic will be down to 48 hours. I hope that that will not lead to what has happened in primary care. The goal of 48 hours has sometimes been taken to represent the time by which appointments must be made, and poor unsuspecting patients have telephoned at 8.30 am hoping that they can secure an appointment because they are unable to make one further in advance.
	The Department of Health has certainly taken on board many of the concerns about obesity reported by our Health Committee. I am delighted with the promise of clear and effective food labelling, and I am pleased that the food industry seems to be beginning to realise that it has a part to play. Although I must admit that I enjoy the occasional Burger King, representatives from both Burger King and Pepsi-Cola are coming to see me later in the week, when I hope to persuade them that they are part of the solution.

Richard Taylor: I thank the hon. Gentleman for that intervention. The Health Committee report virtually bent over backwards in its efforts not to condemn such people for what had happened to them. It is increasingly recognised that obesity is not in all cases simply a question of diet and exercise; some people have definite medical conditions that make matters more difficult for them.
	I turn to exercise, which is also terribly important. The Department of Health recognised in its White Paper the importance of walking to school, which, along with walking to work, is by far the most effective way to get people to exercise. I hope that the teaching of health economics and food technology, which is currently limited to cooking clubs and such like, will become part of the curriculum.
	So while I welcome the White Paper on health, I fear that it could be just words, but I am certainly hoping that it will lead to action. The Secretary of State himself said that it is the start of the journey, not its end, and that it is the vision of the future. There are some milestones by which we can judge whether success is coming. First, will the target concerning the provision of fruit in school for four to six-year-olds be achieved by the end of this year? The new rules on alcohol advertising are supposed to be introduced by the beginning of 2005, so we will be able to see whether they have an effect. On salt reduction, Sir John Krebs says:
	"The food industry is about two-thirds of the way to reaching our target of a 1g reduction in processed foods by the end of 2005."
	Will the industry achieve that reduction completely by that date? On food labelling, the recommendation is that the effective new system of "traffic light" identification of good foods and less healthy foods be in place by early 2006. We will watch very closely to see whether the targets are met, and whether the achievements match the Government's hopes and aspirations.
	I have some other concerns, the major ones being the Government's review of arm's-length bodies and the abolition of the Commission for Patient and Public Involvement in Health, which has been in place for only a very short time. My worry is that this body, which supports the vital patients forums, is being taken away before the proper follow-up arrangements have been made. Such arrangements are crucial. The commission itself is fading away—its chief executive has already moved—so it is vital that we get alternative plans in place quickly.
	I am very anxious about two other vital arm's-length bodies: the Healthcare Commission and the Commission for Social Care Inspection, which are crucial to the Government's monitoring of developments. I met the chair of the CSCI just last week, and I was delighted to hear that she is re-examining its method of inspecting facilities. She is determined that most future visits be unannounced, and she intends to concentrate on the views of users of the services that the CSCI inspects. But will she be able to do so? Are the Government going to grant her the extra funds that the CSCI will need to carry out the extra duties that it will have to take on?
	I have always been a critic of star ratings, and particularly of that ridiculous thing called the "balanced score-card approach". It simply eroded patients' opinions of the health service and did not allow their views to be taken into account in the star ratings. I am delighted, therefore, that the Healthcare Commission is also planning unannounced visits. It plans fewer visits, but wants to co-ordinate them with other visiting bodies, which is absolutely crucial.

Martin Smyth: I am happy to be able to share in the debate on the Loyal Address because I was beginning to think that it was actually just a little England debate, bearing in mind that the NHS stretches across the country and that standards will affect different levels. Last Thursday, I drew attention during business questions to the problems of waiting lists, and the Leader of the House said that we could learn from England. I should be happy if those in England could help us by telling us how they have managed to reduce their waiting lists so well.
	I acknowledge the fact that there has been a reduction of about 2,000 in our waiting lists in the past two years, but the Secretary of State for Health was on the watch when they were rising in Northern Ireland. Whereas waiting lists in England are down—552 people have had to wait for 12 months, according to the information given to us—we must face the fact that, in Northern Ireland, about 3,500 people have waited for between 12 and 18 months, and even beyond. On that aspect, I should like to have some guidance so that we might learn from England; or are Northern Ireland Ministers not getting the proper advice from their departmental officials, so that they can act accordingly?
	I wish to raise again the issue of our primary care provision in the light of the comments made by the hon. Member for Wyre Forest (Dr. Taylor). Throughout Northern Ireland, we are trying to return primary care to the front line, yet some general practices are not properly equipped even to meet the required standards in terms of insurance and health and safety. I understand that, as money is not ring-fenced, the health boards can decide to do what they want with it and that, at the end of the day, we may be hindering the advances in the care in the community, which was one of the key factors of the Government's activity.
	I wish to raise a personal issue that affects one of my constituents—a young lady who was born with a certain problem that ultimately affected her physical aspect and her vision. She attended Jordanstown school and was supposed to be statemented each year. It would appear that, somewhere along the line, the Belfast education board did not do its work—it claimed that it was not invited to do so, but it was always advised when the statementing was done.
	My constituent was advised that she should attend the Royal National College for the Blind in Hereford, and she has done so and that will be paid for until December, but because she will be 19 years old in December, there can be no further funding from the Belfast education board, nor from the Department. I understand that, if she were from England, her education could be funded by different means. There is a method of doing so because the principal of the royal college in Hereford has been in touch with me on that very point.
	The Belfast education board says that my constituent could be funded for vocational training, but not for academic training. I understand that training for her physical condition means that she is now mobile after being wheelchair bound. With the Department of Health and the Department for Education and Skills supposedly working together, there should be a way forward. It is discrimination of the worst kind if a person with a physical handicap who could take the academic route is not allowed to take it because they have been shunted off into another siding.
	I have raised on the Floor of the House in the past the issue of the Departments working together, and I have followed the contributions made this afternoon that dealt with sex education in schools. Love for Life, which was founded as a charity by a medical doctor to do something positive, was funded by grants particularly from the Southern Education and Library Board to work in schools. It met a tremendous response from teachers, children and parents but, unfortunately, the Department of Health says that it now cannot fund it because the charity deals with education issues, and the Department for Education and Skills says that it cannot fund it because it deals with health issues. A Government who pride themselves on being seamless should begin to get their act together so that youngsters are taught not simply the mechanics but all aspects of relationships. That will help them through life and save on wasteful expenditure. They may get into trouble by contracting sexually transmitted diseases because we failed them in the early days.
	There are many other subjects that I would like to raise, but I think that I have said enough. However, I want to make one final simple point. Gulf war syndrome has now been recognised as an illness. I have fought on the issue for a long time, and I trust that we will no longer withhold the financial aid and help so that soldiers who served this country faithfully in the Gulf war now receive the treatment that they deserve.

David Rendel: The themes of this Queen's Speech are "opportunity" and "security", and education is primarily seen in terms of opportunity. We are no strangers to this idea. In the prelude to the party's constitution, we make it clear that "freedom from ignorance" is critical to the liberty of the individual. Education, however, is also of critical importance to security, and I intend to spend a few moments talking about that.
	The other evening following the Gracious Speech, I co-sponsored a House of Commons reception to celebrate the 10th anniversary of a small non-governmental organisation, Development in Action. It is run by young volunteers who have been to India on various projects and who have returned to this country to encourage interest in global issues. They produce a quarterly magazine that goes to students, teachers and careers offices and have created a development education resource base.When I talked to some of the volunteers, I was struck by the vital links that exist between education, the idea of global citizenship and the prospects for greater tolerance and understanding across the borders of geography, imagination and economic opportunity that divide our world.
	On 15 November, the Secretary of State for Education and Skills announced the international strategy for education, skills and children's services. In doing so, he said:
	"One cannot truly educate young people in this country without the international dimension being a very significant and real part of their learning experience."
	Proposals include twinning every school in England with a school overseas within the next five years, and sharing Britain's educational expertise and resources with the developing world. This is all very welcome, and I congratulate him on his initiative. However, it risks being little more than a public relations stunt unless there is a genuine drive to expand foreign languages provision, as proposed by Tomlinson, and to ensure that the "international dimension" becomes a fundamental part of the education reform agenda. Too much of Government policy at present seems to run counter to those principles. One example is the Home Office policy of charging international students for visas despite the fact that fees income from non-European Union students already makes up 7 per cent. of the UK higher education sector's budget.
	A second example is the decline of modern language teaching, and especially—this brings us back to security—a recent report by the British Society for Middle Eastern Studies that argues that we are not training sufficient people with knowledge of the middle east and competence in Arabic languages. Clive Holes, professor for the study of the contemporary Arab world at the university of Oxford, argues that we are seeing
	"the gradual loss of a national resource for teaching Arabic and other Middle Eastern languages, and . . . because of the concomitant staff cuts, the loss of expert advice which should be available to government, the diplomatic and intelligence communities, and business."
	I hope that the Secretary of State will comment on the report in his winding-up speech and give us his assessment of the likely impact of the Higher Education Act 2004 on the situation that Professor Holes describes.
	I turn to the theme of opportunity. The Gracious Speech says:
	"My Government attaches the highest importance to extending educational opportunity so that all individuals can realise their full potential and the country can benefit from the talents of all its people"—
	hear, hear. However, why then do the Government seem intent on erecting barriers to that opportunity? Liberal Democrats deeply regret that the Government have not used the Queen's Speech to announce a rethink on tuition and top-up fees. It was their last chance to do so before we take the issue to the country. The Liberal Democrats' alternative Queen's Speech proposed a Bill to scrap the tax on learning. The electorate faces a clear choice: top-up fees under Labour, commercial interest rates on student loans under the Tories—in both cases, of course, that means that students will pay for their own education—or an end to all charges for university tuition under the Liberal Democrats, with the cost borne by the richest taxpayers.
	Let us remember what happened at the last general election. Such was the hostility to tuition fees on the doorstep that the Prime Minister ordered a review of student finance, with the aim of
	"tackling the problems of debt and the perception of debt".
	Quite how Ministers, proceeding from that starting point, came up with top-up fees as the answer to our woes will no doubt make an interesting case study in university politics seminars for many years to come. I hope that at least some students will enjoy spending £3,000 to discuss it. Following the by-elections in Brent, East and Leicester, South, Liberal Democrats look forward with anticipation to the doorstep reaction that the Prime Minister's loyal servants will receive from voters next spring.
	One measure that Liberal Democrats very much welcome is the proposed child benefit Bill. The Gracious Speech told us that that will
	"extend financial support for 16 to 19 year olds engaged in training and education."
	That will be a step, at least, towards a more equitable system. Liberal Democrats have long championed the needs of part-time students, not least by ensuring that they are covered by the fair access arrangements in the Higher Education Act 2004. We hope that the Government will move towards activity funding so that we can end the funding anomalies that disadvantage students in colleges. We regret that the recently published grant letter to the Learning and Skills Council failed to move us in that direction. The Government's preparedness to support the further education sector will be a key test of their commitment to the principle of opportunity.
	We also welcome the proposal to ensure that the charitable status of independent schools will be dependent on whether they actually do work that is commensurate with that status. We have long argued that charitable status should not simply be a means by which fees can be held down for parents who can afford private education for their children. It should be about opening services and facilities for the benefit of the wider community.
	Liberal Democrats' disappointment with the Queen's Speech stems not only from the fact that it contains measures with which we disagree and fails to contain others with which we would agree, but from the more profound fact that it shows a lack of philosophical direction—a sense of what the Government want our country to look like. Instead we have a mix of reactionary illiberalism and mean-spiritedness, and one or two sticking-plaster-type measures that are welcome, but will do little to help to clean up the mess.
	In education, after three years of debate and a radical Act of Parliament, we are yet to see any real analysis of what the Government think that higher education is for, beyond performing a service role for business. Moreover, the Government may be tough on insecurity, but they are certainly not tough on the causes of insecurity. We live in a world in which 115 million children have no access to education, but providing that for them would cost $5.6 billion dollars, which is comparable to the £3 billion cost to this country of the Iraq war. Was bombing Iraq a sensible priority to set if we are interested in security, let alone opportunity? Which of those priorities would have been a better investment to fight the war on terror?
	Perhaps it says it all that the international agenda for education that I praised, which strikes at the heart of our shared aspirations for a world of security and opportunity, has found no place in the Queen's Speech in the run-up to the general election campaign. The Government have made their choice: they will run with the politics of fear, but not the politics of hope.

Tim Collins: I start on a sober note. I am sure that the House will share a sense of shock and deep sadness at today's horrifying news that a 15-year-old schoolboy has died, apparently after a fight involving another pupil at his school. The thoughts and prayers of every hon. Member will be with the family and friends of all those affected. I hope that all parties in Parliament will come together to act on the persistent calls from teachers for new legal protections and powers to help them in their vital task of upholding discipline in our schools.
	Let me respond to the words of the Health Secretary straight away, because some of the things that he mentioned, too, are above party politics. All of us, without exception, pay tribute to the dedication, professionalism and sheer hard work of those in our public services—our nurses, doctors, teachers and others. All of us admire them, praise them and support them. As my right hon. Friend the Member for Charnwood (Mr. Dorrell) said in his superb speech, we all celebrate the genuine progress that they have made since 1997, as we do the achievements that they secured between 1979 and 1997. There should be nothing between any of us on that subject.
	The question is not whether we back our NHS and education professionals, but how we do so. The Secretary of State came up with an interesting phrase. He said that we have been on a journey with our public services since 1997. He will forgive me if I observe that parts of the journey have been circular in nature. We started by moving away from GP fundholding, and we are now moving back towards it. We started by moving away from grant-maintained schools, and now we seem to moving back towards those as well. As my right hon. Friend explained, we started by moving away from city technology colleges, and now we are moving close to them again, with city academies. We started by increasing the size of the Department for Education and Skills and the Department of Health, and now the Government say that they want to slim them down again. We have had an interesting journey, but the start and end points have not been terribly different.
	The Secretary of State also said—I think that I am quoting him accurately; I am sure he will correct me if I am not—that the Government had met every target and every pledge. That will come as news to those who are still waiting for access to an NHS dentist, which the Prime Minister told them in a speech in 1999 they would get throughout the country by 2001. The Secretary of State said that many of the problems that have occurred in 2004 are the results of decisions taken by past Conservative Governments 10 or more years ago. However, I am sure that he would not expect the Prime Minister to have made his pledge in 1999—two and a half years after Labour came to office—unless he had properly researched it. The Prime Minister obviously believed in 1999 that he could secure universal NHS access by 2001. When he made that pledge, he was fully aware of exactly what capacity was in place and what was not.
	My hon. Friends scored a bull's eye against the Secretary of State when they pointed out that he rightly said that we should praise NHS staff, but seemed alarmed by the prospect of allowing them to decide their own budgets and run the NHS in their own way.
	One of the things that happens in the House is that we are tempted to oppose the party that we would like to be up against, rather than the party that we are up against. I put that gently to the right hon. Gentleman, because I have been guilty of it at times. Some years ago, the Secretaries of State for Health and for Education and Skills were considerably to the left of where they are now. I admit, politically inconvenient though it is, that they have moved and that I cannot make that charge against them. On the same basis, however, the Secretary of State for Health cannot make the accusation that the Conservative party stands for charging people for operations, that we would cut NHS spending or that we would introduce the black death—which I think was the next thing that he would have come to in his litany.
	Nor is it the case that the Conservative party will introduce a 5-plus for every primary school, as the Secretary of State for Education said we would, or that we would forbid schools from taking postcodes or geography into account in their admissions policies. I understand why he believes that that might have been our policy but I assure him that it is not. I wish to make it absolutely clear that that is not the Conservative party's policy.
	Let us consider what has been said in this constructive debate. It is—

Tim Collins: It is clear that giving schools complete freedom to decide their own admissions policy does not involve banning them from taking into account the postcode—[Interruption.] It is all very well for the Minister for School Standards to make a sedentary intervention, but the Secretary of State made two charges, and he has now withdrawn one charge, so we have made progress.
	The policy on schools having freedom means that head teachers will be able to decide for themselves the admissions criteria that they wish to apply. If the Secretary of State believes that there are many state school head teachers who want to introduce either a 5-plus or 11-plus examination, he is even more out of touch with teachers than I thought he was. Of course that is not what they want to do. It is another Labour scare story suggesting that professionals should not be trusted to take decisions themselves.
	The hon. Member for Huddersfield (Mr. Sheerman), who chairs the Education Committee and who is not in his place at the moment, made an extremely good speech in which he talked about the need to build on and learn lessons from Sure Start—both its successes and its failures. That is certainly something that we would like to do. He welcomed the Government's proposals to reduce the amount of bureaucracy in Ofsted. At the same time, he expressed some interesting concerns about light-touch regulation. Interestingly, he was also quite cautious about reducing the role of local education authorities. Similarly, it will be interesting to see whether the Secretary of State will go as far as the Chancellor of the Duchy of Lancaster has in advocating cutting LEAs out of education entirely.
	The hon. Member for Huddersfield said that he thought that the ballot arrangements for abolishing grammar schools were unfair. The Opposition would agree with that. The conclusion that we would reach is to abolish the balloting mechanism and leave grammar schools to continue with their work, not threaten them all the time.
	The most amusing comment made by the hon. Gentleman was that the Prime Minister and the Chancellor of the Exchequer are a close-knit team. That is not exactly the phrase that would come from most of our lips.
	My right hon. Friend the Member for Charnwood made an extremely good speech, parts of which I have already looted in some of my remarks. He talked about the way in which the Government are bringing back GP fundholding and implementing our policies on city academies policies, albeit that they are doing it under a different name. His central theme, which was absolutely right, was that the Government have now decided that it is electorally popular to talk about choice in education. However, people know that they will not get choice from a Government who at best have a half-hearted belief in choice, and are divided about it. They support the word but not the idea. People will get choice only from a Government formed by the Opposition, who are determined to make choice a reality.
	The hon. Member for Crawley (Laura Moffatt) said that a great deal of money had been spent in her constituency. I am sure that that is entirely true. She said that she believed that ideas and concepts were not relevant unless there were the resources to implement them. We, the Opposition, would say that resources alone will not achieve much without the right structures or the correct empowerment of parents or pupils—and that, sadly, has been the story of much of the past seven and a half years.
	My hon. Friend the Member for Bognor Regis and Littlehampton (Mr. Gibb), in a typically thoughtful and wide-ranging speech, made some extremely powerful comments about the need to move towards the use of phonics, a return to teaching by rote, setting and less use of mixed-ability teaching. In response to his comment that he thought that this is something about which politicians should express preferences and views, I hope that he will have noticed that my right hon. and learned Friend the Leader of the Opposition, in his speech on education yesterday, specifically committed our party to sponsoring the expansion of all those things, for precisely the reasons that my hon. Friend addressed.
	The hon. Member for Colne Valley (Kali Mountford) rightly praised my hon. Friend the Member for Bognor Regis and Littlehampton for his speech, and made an excellent speech herself about the need to focus on the prevention as well as the cure of illness, and to develop the healthy schools initiative. I am sure that she shares my disappointment that the Prime Minister, in his party conference speeches in 1999 and 2000, made promises that were not kept. In 2000, he said that £750 million of lottery money would be spent on new school sports facilities in the succeeding three years. By February this year, however, of that £750 million a total of only £8.5 million had been spent. That is disappointing, and I agree with the hon. Lady about the importance of the issue.
	My hon. Friend the Member for Lichfield (Michael Fabricant) said that 200,000 people have had to go private because they cannot wait for their operation on the NHS. He also made powerful constituency points about animal rights protestors. My hon. Friend the Member for North-East Bedfordshire (Alistair Burt) made some sensible comments about school sport. He also made some extremely powerful points about the need to get the balance right in sex education. He is right to say that we should all review the balance and scope of sex education in our schools, and can learn lessons from European countries that have been more successful in this field for many years under successive Governments. He also spoke about the wisdom of listening to people who represent different faith groups and people who, like my hon. Friend, practise a faith.
	The hon. Member for Wyre Forest (Dr. Taylor) talked about the food industry and food labelling, and secured an important clarification from the Health Secretary about his position which, I understand, was misrepresented in some of this morning's newspapers. The hon. Member for Belfast, South (Rev. Martin Smyth) made an interesting observation about the reason why waiting lists in Northern Ireland are much longer than in England. Lessons certainly need to be learned, and I strongly agreed with his conclusion about the need to provide support for people suffering from what is called Gulf war syndrome. The hon. Member for Newbury (Mr. Rendel) rightly highlighted the distinction between the Government's words about opportunity and their action in introducing top-up fees.
	The contents of the Queen's Speech are, in many respects, disappointing. The School Transport Bill is carried over and will strip parents of a 60-year-old statutory entitlement to free school transport. That will permit, then encourage and ultimately, we fear, require local authorities to charge for that service. Two thirds of current subsidies for school transport benefit special needs children, who will lose out, as will parents who are far from wealthy, and people in rural areas.
	The child benefit Bill, on the other hand, will address a genuine and long-standing anomaly, so we welcome it. Unfortunately, it has been packaged with measures that will result in the introduction of new and higher charges for adult learners in further education colleges. I would be grateful if the Secretary of State for Education and Skills commented on something that my hon. Friend the Member for Epsom and Ewell (Chris Grayling) told me this afternoon—that the Association of Colleges has been told by the Learning and Skills Council that any revenues that it raises through the extra charging regime will be clawed back by the Treasury. In other words, the money would not be additional, which is a deeply disturbing development.
	The schools Bill will include a number of measures that the Opposition do not find any difficulty in supporting, as they will make it easier and quicker for schools to achieve foundation status. They will also establish a three-year rolling budget and slim down Ofsted. We support those excellent measures, having called for them for a considerable period. However, we believe that the Bill is uncontroversial not because it is perfect, but because it is a half-hearted stab at what is necessary. Foundation schools have limited freedoms: they do not have control over admissions, have no final say over expulsions, and cannot commission or control all works on their site. They do not have the right to decide entirely for themselves whether to expand, alter working conditions or impose home-school contracts as a condition of admission. Schools need those freedoms, but they are not granted in the Queen's Speech.
	The Queen's Speech that we should have had would involve a right to choose Bill, scrapping the surplus places rule, encouraging and funding good schools to expand, allowing parents to take state funding to any school of their choice, and ensuring that an extra 600,000 parents get their first choice of school in the lifetime of the next Parliament. We should have had a teacher protection Bill, giving teachers accused of misbehaviour a guarantee of anonymity until they are charged, giving head teachers the final say on exclusions by abolishing independent appeals panels, and providing for a massive expansion of high quality separate provision for pupils who end up excluded.
	We should have had a higher education Bill to scrap tuition and top-up fees, to transfer the huge asset of the student loan book to universities to make a massive improvement in their finances, and to scrap outright the disgraceful post of university access regulator, because access to university should not be politically determined.
	As ever, we must judge the Government not on what they say, but on what they do. What we got in the Queen's Speech was more spin and all talk. What we needed was more choice, more discipline and higher standards. After seven and a half years it is clear that we will not get any of that from more Queen's Speeches from Labour. We will get it only from the first Queen's Speech of the next Conservative Government.

Charles Clarke: Not, at the moment.
	I shall respond to a point made by colleagues in the debate, particularly my hon. Friends the Members for Huddersfield (Mr. Sheerman) and for Tamworth (Mr. Jenkins) and the right hon. Member for Charnwood on the role of the local authority. For us, that is exceptionally important in relation to children's trusts, as the hon. Member for Sutton and Cheam (Mr. Burstow) mentioned in his speech, as well as in the delivery of the whole 14-to-19 agenda, and in relation to the school improvement responsibilities mentioned by my hon. Friend the Member for Huddersfield and the various ways in which school performance can be raised, as set out by the hon. Member for Bognor Regis and Littlehampton (Mr. Gibb). I cite particularly to my hon. Friend the Member for Tamworth the importance of the vocational pathways which, following the Tomlinson report, will be critical to the 14-to-19 group and in which the local education authority will have an essential role. I was glad to hear that the official Opposition will give general support to the Bill, and I hope that we can make progress on it.
	The second Bill is the School Transport Bill. Given the comments of the hon. Member for Wyre Forest, I hope that we can rely on his support. I ask both main Opposition parties to consider reversing their blind opposition to the proposals. As their colleagues in local government, Conservative and Liberal Democrat, well know, those proposals are supported by councils that want to be freed in the way that our pilots propose, that want to deal with congestion and the school run and that want to achieve healthier approaches. I urge Opposition Members not to persist in opposing the Bill.
	The third Bill that I shall refer to is the draft Bill on contact and inter-country adoption—a key measure that follows the Green Paper to which I referred in an exchange with the hon. Member for Sutton and Cheam. It is a very important measure for a variety of reasons, but it is intended to give the courts more flexibility and powers to underpin and enforce contact orders in cases of parental separation. The measures in the draft Bill are very important and substantial. They will help to encourage and underpin productive contact arrangements in the best interests of the child. I say to every Member of the House that it is the best interests of the child that must be paramount in these considerations. There have been one or two knee-jerk posturings on this matter, not least from the right hon. Member for Maidenhead (Mrs. May), which I think need to be addressed directly. I hope that we will have a proper debate on the draft Bill and agree that getting it right is important.
	The final Bill that I want to mention is the one on child benefit. I was glad to hear the comments of the hon. Member for Newbury (Mr. Rendel) and of the official Opposition in giving general support to this measure, which is also very important.
	This is a substantial legislative programme for education that is part of the reform component of our overall strategy of investment and reform, which is central to everything we do. In July, we published our five-year programme for under-fives, schools, skills and lifelong learning, and the measures provide a substantial commitment in those areas. In the context of this debate, it is perhaps worth adding that health in schools and the public health White Paper published by my right hon. Friend the Secretary of State for Health are a key component in that joint work.
	I noticed that a number of contributors—in particular, my hon. Friend the Member for Colne Valley (Kali Mountford), who made an outstanding speech, as well as the hon. Members for North-East Bedfordshire, for Lichfield and others—focused on the health education element of the proposals. I think that that reflects joint working between the Department of Health, my Department and all our agencies to deliver high-quality education and health in every school in the country. That is done through information, integrating services through children's centres and children's trust arrangements, developing extended schools everywhere in the country, extending the school nursing service, establishing healthy schools in every area, investing to improve nutrition in school meals, active travel plans, school sports partnerships and funding through the whole range. That is a key element in our overall programme—a health and education programme that takes us forward.
	In truth, reform is not enough in these areas; it is investment and reform that are needed, and the investment story too is immensely substantial. Today, my hon. Friend the Minister for School Standards announced our building schools for the future programme. It is worth setting out the figures, because they are so stark and impressive. We inherited total capital spending of £683 million in 1996–97. By 2005–06, the next academic year from now, the amount will have increased to £5.5 billion—a massive increase in spending.

Charles Clarke: Yes, I can, and in two ways. First, every school will benefit, whatever its situation and whatever the PFI project. By next year, the amount will be £25,500 in a typical 250-pupil primary school, or in a typical 1,000-pupil secondary, there will be £87,250 in devolved capital for what the school has to do. Beyond that, whatever the particular programmes, such as the PFI in Norfolk to which the hon. Gentleman referred, and despite the difficulties, the commitment will remain precisely as it has been in the past.
	The central point that I am making is that the financial commitment to the proposal is overwhelming. The building schools for the future programme that we have set out today is a transformation of education in this country that will enable improvements in every community in every part of the country.
	Both on investment and on reform, there is a straightforward, clear choice between the Opposition and the Government. The choice on money is whether more money should go into education, as we propose, or whether money should be taken out of education, as the Opposition propose. The shadow Chancellor made it clear that spending outside schools, which means under-fives, skills, universities and all those other areas, will be frozen at 2005–06 levels. That was his clear commitment, which means real terms cuts in every other area.
	The Opposition's proposed pupil passport would mean at least £1 billion going from state schools to private schools. In contrast, this party will continue to increase spending by at least 6 per cent. per year. from 2005–06 to 2007–08 and provide high quality, flexible, affordable child care for all parents. That is one dividing line: more money from us; less money from the Opposition.
	The second dividing line is opportunity for all, which we offer, versus selection for the few, which the Opposition offer. We require the strict application of the admissions code of practice for all schools and no extension to selection by ability. As the hon. Member for Westmorland and Lonsdale confirmed in an exchange a few moments ago, under the Opposition, every school would be able to decide its own admissions, opening the door to five-plus and 11-plus selection. Above and beyond that, the hon. Gentleman, speaking in March this year to the Secondary Heads Association, said that he wanted to get rid of catchment areas for schools. Again, there is a direct choice: opportunity for all, which we offer; selection for the few, which the Opposition offer.
	The same dividing lines arise on standards. We say, "High ambitions for every school and pupil"; the Opposition say, "No ambitions for schools and pupils." Targets have been established, and schools are responsible for local target setting to encourage all young people to achieve the top grades. The Opposition would scrap the targets and limit the number of children who can achieve the top grades by introducing quotas.

Charles Clarke: Sir Keith Joseph, holding the office that I now hold, recognised the lunacy of what the hon. Gentleman has just said by abolishing such a proposal. The hon. Gentleman wants to go to the right of Sir Keith Joseph, when Sir Keith Joseph was Secretary of State for Education, by failing to recognise everybody's ability to do better for themselves.
	There is a dividing line on freedoms. We say, "More freedoms for all schools"; the Opposition say, "A free for all." We want freedom for secondary heads and governors to improve their governing bodies, set three-year budgets and create a framework for fair admissions; they want to create chaos by abolishing the codes of practice on admissions and by scrapping appeal panels, which would create a charter for lawyers.
	On local education authorities, the division is clear too. We want a new role for local authorities in the areas that I have set out—children's trusts, those aged 14 to 19, child care and strategic leadership for education and school improvement. The Opposition want to abolish local authorities, funding schools directly by bypassing local government entirely. They are also considering the outright abolition of LEAs.
	The Queen's Speech clearly sums up the choice in each of those areas: more money for us, less money for them; more freedoms for us, a free for all for them; high ambitions for us, no ambitions for them; and opportunity for all for us, selection for a few for them. In conclusion, we say, "Every child matters"; the Opposition say, "Only a few children matter."

Child Support Agency

Annette Brooke: I want to use this opportunity to highlight just a few of the problems experienced by the many constituents who contact me about the difficulties that they are experiencing with the Child Support Agency. I realise that almost every MP must have a similar size mailbag on this issue, so it is not surprising that the CSA has written off more than £2 billion of uncollected child maintenance since it was set up. In addition to illustrating the all-too-common problems experienced, I wish to highlight the tragedies underlying the facts. To do so, I want to concentrate on one particular case.
	I first met my constituent, Ms E, in 2001. She initially became involved with the agency in 1993. I made a personal commitment that I would do my utmost to help her. At that stage, I had no direct experience of the Child Support Agency, and I had no idea of the difficulties that lay ahead. The agency tells me that between 1994 and 1997, it unsuccessfully tried to find a "confident" address for the husband, to whom I will now refer as Mr. X, despite receiving information from Ms E and other Government departments.
	At one stage, Mr. X behaved very violently, and forced Ms E to sign that she would not claim maintenance. The violence continued on and off, and in 1998, Mr. X was sentenced to 60 hours' community service. Not surprisingly, Ms E became extremely distressed, and felt that she just could not cope with the system any more. On 21 May 1997, the case was closed, as good cause had been accepted, because of the risk of harm to her. However, she wrote to the CSA in July 1999, requesting that her case be reopened, but did not receive a reply until 2 October 2000—a delay of 15 months. The agency has explained that that was unfortunately due to the work in hand at that time.
	More attempts were made to contact Mr. X between October 2000 and April 2001, but they elicited a straight refusal by Mr. X to confirm any details or to complete the maintenance inquiry form. The agency gave up entirely on 9 April 2001, although Ms E was advised that it would issue an interim maintenance order in February 2002. My inquiries revived the processes in March 2002.
	The agency sent a further maintenance inquiry form to Mr. X at an address provided by Ms E, and an inquiry was sent to the Inland Revenue. However, the agency wrote to me blandly in July that year to say that
	"to date no information has been received",
	and to apologise for not even making progress with action on information that had been supplied about a vehicle driven by Mr. X.
	At that stage, my constituent was awarded a paltry £85 in compensation for all the inefficiencies. She returned the cheque.
	The agency requested a physical description of Mr. X. That had long since been supplied, but nevertheless a further photograph was sent. In July 2002, the agency assured me that if Mr. X failed to comply with the request for information he would be taken to court, with a possible fine of £1,000. I wrote a further letter to the agency in September 2002 pointing out that over eight years no help had been received from Ms E's former husband, that information had been repeatedly supplied, that as a community sentence had been given names and addresses must be available, and that at that time the children were seeing their father nearly every weekend at his parents' house.
	A reply dated 24 September 2002 said that Mr. X had not attended an arranged interview, and that the agency was preparing an interview under caution. Mr. X did not turn up for that interview, but no follow-up action appeared to have been taken. On 23 October 2002  I wrote to the then chief executive of the CSA, Mr. Smith, asking whether, given the eight-year wait and the inertia demonstrated by the agency, the case could be given national priority. No progress was made. On 27 November 2002 I wrote to the Secretary of State for Work and Pensions, but my letter was simply passed back to the chief executive of the agency.
	On 20 December 2002, the CSA informed me that it had now received new details of Mr. X and would be arranging another interview. Mr. X rang the agency on 4 February 2003 to say that he could not fill in the form that it had sent because he was waiting for financial information. At least a proven address had finally been confirmed—but apparently the face-to-face team works only from nine to five from Monday to Friday and home visits are undertaken reluctantly, so no progress was made.
	Was this not, by now, a pretty exceptional case, given that there could have been more persistent chasing? I understand that there has been a fear of violence over the years, but is not some protection offered to face-to-face teams in such cases?
	On 24 June 2003 I heard that accounts had been received from Mr. X, but to date still no payments have been received. The current position is that Ms E has raised questions about the income declared by Mr. X, given his present lifestyle.
	I can conclude only that the agency has made no more than token efforts to obtain any maintenance for Ms E's daughters. There has been no consistent and persistent attempt over the years to challenge the many prevarications, or indeed in recent months to check information supplied by Mr. X. Enforcement action has now been initiated, and Ms E completed a long form earlier this month. So far she has been rewarded with yet another form to complete, this time 36 pages long. I do not think that she can cope with the new form.
	I need the Minister to understand how my constituent feels. She has been left struggling for 11 years; she finds herself drained of effort, and has no confidence in anyone. She cannot afford to work without the maintenance, although she would have liked to pursue her career. She feels that her children have been denied a reasonable lifestyle for 10 years. In the case of Mr. X, we are not talking about somebody who has fled the country. Throughout this long period, my constituent's ex-husband has never lived further than two miles from his place of birth.
	Ms E asks:
	"Why is it taking so long for my rights and the rights of my children to be recognised?"
	Christmas is a very hard time for her. She feels upset and angry that she cannot provide for her children as she would wish. An undertaking from the Minister that she will personally monitor this case until a conclusion is reached might provide some hope for my constituent this Christmas.
	I want to comment briefly on some other issues that I frequently encounter, and to refer to six particular cases. In the first, the husband and wife are each in a second partnership. The wife receives no maintenance for her children from the previous marriage, despite a long history of trying to work through the agency; the husband is faced with numerous errors and is being asked to pay too much. The result is a phenomenal strain on the new partnership, and particular difficulties in the relationships with each set of children. That case highlights inconsistencies in the intensity with which people are pursued, and in the degree of enforcement.
	In the second case, a husband who was in a second relationship had the new formula applied to him after an interval of many years; the previous wife had not requested maintenance. He checked with the CSA to see whether he was likely to be required to make payments in future. He then took on a large mortgage in order to accommodate a total of five children. Of course, the new formula does not take into account housing costs, which are very high in my part of the world, and he was simply unable to pay the amount imposed on him. Personnel at the agency warned him that the bailiffs would be sent in. He became absolutely desperate. I could not persuade the agency to phase payments in a way that he felt he could cope with. Apparently, he has just given up his job. That does not seem a satisfactory outcome. A case such as this emphasises the inflexibility of the current system and the often unintended consequences.
	In the third case, the wife informed the CSA of her former husband's employer. The CSA contacted the employer and was told that it had never employed her former husband. The CSA just accepted that as a true answer, and I have had to intervene to make sure that further employment checks are made. The wife felt that the CSA simply did not believe her, and that she was being regarded as a liar.
	In the fourth case, a letter from a constituent, written in November of this year, states:
	"I have now been waiting since 4 August 2003 and still nothing. They have all the details."
	In acting on this letter, I received a prompt reply from the CSA, which is good. It now says that it will establish why the deduction-from-earnings order has not been made. But are there no follow-up procedures within the agency itself?
	In the fifth case, Mr. T has been advised that the CSA will continue to require payments based on the old system, but that it has calculated that his current payments of some £80 per week for his one child would fall to £27 per week if he were assessed under the new system. The failures of the new computer system are well documented. My constituent feels that this now substantial delay in changing to the new system is causing him considerable hardship.
	In a sixth case, a former husband and wife would both rather opt out of the CSA system because of the increasing incompetence that they face. My constituent writes:
	"A massive increase has been imposed on the maintenance payment I have had to make this month without prior notice or opportunity to review the facts, at a particularly expensive time of year, and I have correspondence from them which shows a different calculation. My ex-wife and I are not confident that the standards offered by the CSA are ever likely to improve and furthermore, and perhaps more sinister, is that our children do not appear to be the prime concern of the people at the CSA."
	That is a very telling point. My constituent continues:
	"To this end, we want the CSA to cease its involvement in our case and let us take control of our own affairs with regard to the wellbeing of our children—something we feel the CSA has gravely overlooked."
	They both signed a document of intent and I would be grateful if the Minister would confirm whether they can manage their own affairs in the way they propose. That would save me having to write a letter.
	Unsurprisingly, I believe that the CSA should be scrapped, so that a balance can be found between rigidity and unfairness and the complexities of coping with individual cases. It seems essential to me that, for the difficult cases, there must be an individual-based system. I would like to see a system based on family courts to deal with cases that are not easily resolved, and I would also like to see the Inland Revenue take over some of the functions of the CSA.
	Many people welcomed the system because they all accepted that the non-resident parent should contribute in some way, but the system introduced by the previous Government is not working and it is always a problem to try to fix something that is not working. There are now probably many aspects that are beyond the current Government's control and the new computer system has thrown the system into even greater disarray. Is it not time to bite the bullet, genuinely put children first and introduce a system that will achieve precisely that?

Jane Kennedy: I congratulate the hon. Member for Mid-Dorset and North Poole (Mrs. Brooke) on securing this debate on a subject that is so important to the lives of so many families. I am speaking here in place of the Under-Secretary of State for Work and Pensions, my hon. Friend the Member for Gravesham (Mr. Pond), who usually speaks on matters relating to the Child Support Agency, but is engaged in important European business in Brussels and is unable to attend tonight. I am a poor substitute on this occasion, but I will do my best to answer one or two of the hon. Lady's specific points.
	I would like to start by emphasising how committed I and my ministerial colleagues are to creating an efficient, effective child support service. The new child support scheme is simple, transparent and easier to understand. Ultimately, it will ensure that money gets more quickly to more children. Indeed, already more and more cases are being dealt with under the new scheme, and clients and staff tell us how much they like and understand the new simpler calculation. I add the caveat, "when it works as it should". From the case described in such graphic detail by the hon. Lady, it is clear that it not working as it should in all circumstances.
	I would say that, in general, MPs' surgeries tend to be filled with constituents who come to complain about public service failure. We do not generally encounter those who are perfectly happy with the service that they are receiving or those who are complimentary about it. I will speak in general terms about the CSA's work and what is being done to improve the agency's working, though I will try to touch on some of the hon. Lady's points.
	The Child Support Agency is now effectively clearing thousands of cases each week. More than 33,000 of the poorest families are now benefiting from child maintenance premium payments, which means that, for the first time, parents on benefit see a real advantage from any maintenance paid and at a time when they most need it. Also, because the new scheme is so much easier to understand, parents are more able to make their own arrangements without involving the agency. The one exception is parents who are in receipt of benefits. The interactive calculator on the CSA's internet site regularly gets over 25,000 visits every month, so the hon. Lady can see that the new child support scheme is starting to make a real contribution to supporting children.
	As the hon. Lady will be aware, since the new scheme was introduced in March 2003, the level of service given to some of the agency's clients has, due to difficulties with Electronic Data Systems Corporation's new IT and telephony service, still fallen well short of what they are entitled to receive. For that, I apologise. I am not going to pretend that I and my ministerial colleagues have not been disappointed, and I know that the agency, too, has been frustrated that more parents have not been able to experience the improvements that the new scheme has to offer. However, it continues to work closely with the computer supplier, EDS, to resolve its technical problems, and it is making progress.
	Staff in the agency have to deal with often very sensitive and complex issues, and they deal with people who are in emotionally delicate circumstances, when relationships have broken down. I pay tribute to the staff who work in an already difficult job and who have shown dedication in trying to shield clients from the worst impact of the technical problems the agency has been experiencing.
	The means of getting money flowing is a key issue for those of the hon. Lady's constituents on whose behalf she has written to the chief executive, and I commend the diligence with which she pursues her constituents' cases. Achieving compliance from non-resident parents is a key part of the work of a large number of the agency's staff. It is not true that there is no follow up. At all stages of a case, staff take action to ensure that non-resident parents accept their responsibility and comply with the maintenance calculation. Even before then, staff encourage non-resident parents to make voluntary payments to the parent with care, while they are waiting for a calculation to be made. That helps to prevent arrears from building up at the beginning of a claim. The agency is now placing even greater emphasis on ensuring that money flows between parents as quickly as possible.
	The hon. Lady asks whether I will personally monitor the constituent's case that she has raised this evening in such detail. I undertake to do so, and I will draw it to the attention of my hon. Friend the Under-Secretary of State for Work and Pensions.
	We should be realistic about enforcement. Some parents will fail to co-operate, fail to pay and fail to take the financial responsibility that they have for their own children. Indeed, worse than that, some people set out deliberately to evade their responsibilities. The lengths that some non-resident parents will go to are astounding: they change jobs—the hon. Lady suggested that that might have happened in the case that she raised—move house, become deliberately unemployed or even leave the country to avoid financially supporting their children.

Annette Brooke: Will the right hon. Lady give way?

Jane Kennedy: I was just about to sit down, but I will give way as we have a few minutes left.

Annette Brooke: I thank the Minister for her earlier assurance that she and the Under-Secretary of State for Work and Pensions will monitor the case that I have outlined in great detail. Is it possible for her to put a time commitment on when we might expect feedback? She may well appreciate that, given the time that the case has been going on for, I am anxious to establish whether we might hear something in a month, two months, three months or whatever.

CORRECTION

29 November 2004, in col. 436, after "I urge the House to be extremely careful about theilliberal measures that the Government are introducing." insert the following:

Piara S Khabra: I congratulate the Home Secretary and his Department on a number of proposals in the Queen's Speech. Many of the ideas in the agenda get right to the heart of the concerns felt by many of my constituents. I am sure that there is much in the proposals that they will welcome. I am particularly pleased about the emphasis on security, as the issue of law and order—whether it be concern about drugs, antisocial behaviour or any other activity—features regularly in my constituency postbag. It is not just the victims of crime who suffer. Even non-violent crimes can cast a shadow over entire neighbourhoods; communities are faced day in and day out with graffiti, abandoned cars, noise nuisance and cycling on the pavement.
	With that in mind, the clean neighbourhoods and environment Bill should further equip local authorities to deal with quality-of-life issues, which the residents of my constituency raise with me quite often. The Bill is rooted in the broken-windows theory of crime: if we tackle low-level problems such as fly posting and graffiti quickly and aggressively, we will send a message that will bring down the levels of more serious crime. That method undoubtedly works when applied properly. Although we have to act sensitively when dealing with diverse communities such as those in my constituency, the results can be extremely positive.
	On a completely different scale, I welcome the Serious Organised Crime and Police Bill, and specifically the establishment of a Serious Organised Crime Agency, which will take over a number of functions. It hardly needs saying that we live in an increasingly globalised world, where ease of travel and electronic technology have brought not only great benefit but real challenges, as criminals, not to mention terrorists, can exploit such advances to work across international boundaries. That is especially true of drug smuggling and people trafficking, as well as of the growing problem of organised criminals who smuggle migrants—often at great risk to those migrants; it has been reported many times that migrants have drowned in the sea while travelling—while generating large profits for themselves.
	Tackling those criminal groups effectively will require a co-ordinated response that the new agency should be able to provide. It could also enhance our effectiveness in combating terrorist organisations and their sympathisers who may fund their networks through other criminal activities, as is so often the case. Of course, there are challenges with creating such a new body. As the Police Federation notes, there needs to be an effective integration of the new body into the existing structures, so that intelligence and information are passed on and not lost or withheld in counter-productive turf wars.
	Although the agency will be useful at a national level in challenging drug trafficking, it is essential that we provide the police and courts with the powers necessary to tackle drug use locally. Just last week, I received a fax signed by a number of local shopkeepers who were concerned that groups of drug users and dealers loitering outside their stores were having a damaging effect on local businesses and the community at large. I hope that the provisions in the drugs Bill will therefore go further not just in reducing the number of users but in ensuring that those taken off the streets are given the support and treatment that they need to beat their addictions so that they do not offend again.
	On balance, I support the introduction of identity cards. Various sections of the community oppose the proposal, while others support it. Of course there are real concerns, which should be aired and discussed, but ultimately, as long as the card is used not to create profiles but simply for identification, it should be a means of ensuring that someone is who he or she claims to be. Law enforcement professionals and the public as a whole appear to support the introduction of ID cards—at least, as far as the public are concerned, as long as the card remains affordable. Last week's report that identity fraud occurs every four minutes in the United Kingdom is a sobering reminder of the challenges that we face.
	I am not sure how I feel about the Police Federation's call for the compulsory carrying of cards, as I do not believe that the card will be useless if the law does not compel people to carry it at all times. However, that is probably a moot point, as the Government have said that it will not be compulsory to carry a card. If someone has not broken any law, I do not see why the police would have any further interest in them. The trick will be for the Government to ensure that the system is efficient and secure, so that the public can have confidence in it.
	I also support the introduction of an equality Bill, which is to include a new commission for equality and human rights to replace existing equality bodies and to oversee new laws on age discrimination, sexual orientation and religious beliefs. As a Member of Parliament who represents a hugely diverse constituency, I can certainly see the benefits of a body recognising the challenges faced by different racial and faith groups. However, bringing the issue of equality under a single umbrella organisation should encourage further moves towards fair treatment of all groups, including women, and underscore the point that any discrimination is wrong and will be tackled vigorously.
	As should always be the case, the Government will need to be mindful of the reservations that people may have, and do have, about legislation. When dealing with issues of security, safety and even terrorism, it is all too easy for legislators to undermine a sense of well-being even as—

Madam Deputy Speaker: Order. The hon. Gentleman's time is up.